Utah Woman Faces Charges For Nearly $13 Million In Medicaid Fraud

A Utah woman is facing charges for allegedly defrauding the Medicaid system of millions of dollars over a three-year period. The woman, who was employed at an addiction treatment center, is accused of orchestrating the fraudulent scheme.

Lillian Kaye Simiskey, aged 40, held the position of program director at “Measures of Affect Theoretically Relative” (MATR), a behavior health company that focuses on providing specialized treatment for substance use disorder, according to court documents.

MATR’s “primary place of business,” as stated in the report, was a residential treatment center located in the town of Mount Pleasant in Sanpete County. The company also offered outpatient services at various offices in St. George, Delta, Orem, Murray, and Tooele. Simiskey was responsible for overseeing operations at all of these office locations, according to prosecutors.

According to court documents, MATR became an approved Medicaid provider in 2018. Subsequently, Medicaid revenue gradually became its primary and eventually only source of income.

According to prosecutors, MATR was able to obtain a total of $12,994,704 in Medicaid funds from March 11, 2019, to June 8, 2022. However, they claim that the therapy services offered by the company during this timeframe were not conducted by qualified professionals, failed to adhere to Medicaid regulations, and were supported by falsified documentation.

According to charging documents, Medicaid representatives have stated that the funding for these services would not have been provided if they had known that unqualified individuals were delivering the services and that falsified information was being entered into medical records.

Witnesses informed prosecutors that Simiskey took over at MATR for her mother, Cynthia Jane Marvin, who was a hypnotherapist and one of the company’s founders. However, the charging documents highlight that Simiskey lacked formal education, training, or qualifications in behavioral health or addiction treatment. Prior to joining MATR, she was reportedly employed at a turkey processing plant earning around $10 per hour. Despite this, she swiftly rose to a management position within the company.

According to reports, Simiskey made a total of $1.7 million from January 7, 2019, to July 27, 2022.

Simiskey has been accused not only of fraud at MATR but also of applying for medical assistance benefits and food stamps through the Department of Workforce Services. During the period between January 7, 2019, and March 3, 2020, she claimed that she and her household had no income. However, prosecutors have revealed that both her bank records and those of MATR indicate that she earned $158,095 during that specific time frame.

According to the charges, she was provided with $35,000 through the Medical Assistance Program and over $4,000 through the Supplemental Nutrition Assistance Program based on the “inaccurate application.”

Simiskey is facing a total of nine felony charges in this case.

    • False claims for medical benefits (2nd-degree felony; 2 counts)
    • Tax evasion (2nd-degree felony; 3 counts)
    • Fail to render a proper tax return (3rd-degree felony; 3 counts)
    • Public assistance fraud (2nd-degree felony; 1 count)

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