MT. PLEASANT, Utah — A Utah woman has been charged with defrauding the Medicaid system out of millions of dollars over the span of about three years while working for an addiction treatment center.
Court documents state that 40-year-old Lillian Kaye Simiskey was the program director at "Measures of Affect Theoretically Relative" (MATR), a behavior health company specializing in treating substance use disorder.
MATR's "primary place of business," according to the report, was a residential treatment center in the town of Mount Pleasant in Sanpete County. The company also provided outpatient services at offices in St. George, Delta, Orem, Murray and Tooele. Prosecutors say Simiskey "oversaw operations in all office locations."
MATR became a Medicaid-approved provider in 2018. Soon after, according to court documents, Medicaid revenue became its primary source of income, then eventually its sole source.
Prosecutors said MATR received $12,994,704 in Medicaid funds between March 11, 2019, and June 8, 2022. However, they allege that the company's therapy services during this period "were not provided by qualified professionals, did not comply with Medicaid regulations, and were based on falsified documentation."
"Medicaid representatives indicated that these services would not have been funded if the Medicaid program had known that services had been provided by unqualified individuals and that falsified information had been entered into medical records," charging documents stated.
Prosecutors said they were told by witnesses that Simiskey was taking over at MATR for her mother, Cynthia Jane Marvin, a hypnotherapist and one of the company's founders. However, the charging documents point out that Simiskey had no formal education, training or qualifications in behavioral health or addiction treatment. She was reportedly working at a turkey processing plant for about $10 per hour before joining MATR and "quickly" becoming part of management.
Simiskey reportedly earned $1.7 million between January 7, 2019, and July 27, 2022.
In addition to the allegations of fraud at MATR, Simiskey is also accused of applying for medical assistance benefits and food stamps through the Department of Workforce Services. She claimed that neither she nor anyone in her household earned income during the time between January 7, 2019, and March 3, 2020. However, according to prosecutors, her own bank records and those of MATR showed her earning $158,095 during that time period.
The charges state that based on this "inaccurate application," the State granted her $35,000 through the Medical Assistance Program and more than $4,000 through the Supplemental Nutrition Assistance Program.
In all, Simiskey is charged with nine felony offenses:
- 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)
The charges were filed on Friday by the Utah Attorney General's Office.
