- Lillian Kaye Simiskey was sentenced to a year in jail for tax fraud and fraudulently obtaining funds from Medicaid.
- She is ordered to pay nearly $2.7 million in restitution.
- Simiskey submitted over 7,700 fraudulent Medicaid claims from 2019 to 2022, charges state.
SALT LAKE CITY — A Utah woman convicted of tax fraud and abusing the Medicaid system has been sentenced to a year in jail and ordered to pay almost $2.7 million in restitution.
Lillian Kaye Simiskey, 41, pleaded guilty last week in 3rd District Court to a pattern of unlawful activity, a second-degree felony, plus tax evasion and public assistance fraud, third-degree felonies.
Charges of false claims for medical benefits and three more counts of tax evasion, second-degree felonies, plus two counts of failing to render a proper tax return, a third-degree felony, were dismissed as part of a plea agreement.
Charges were filed against Simiskey in March 2024 and she was sentenced to one year in jail on Oct. 21. Simiskey is ordered to pay $2.6 million in restitution to Medicaid, $59,044 to the Utah Tax Commission and $39,444.95 to the Utah Department of Workforce Services. She will also serve four years of probation.
In February 2021, the Utah Attorney General's Office was notified of allegations that a Medicaid provider had been submitting claims for services fraudulently.
Measures of Affect Theoretically Relative is a behavioral health company that offers substance use disorder treatment, has a treatment center in Sanpete County and multiple offices throughout the state. Simiskey was a board member at the company.
According to court documents, Simiskey and two other individuals submitted more than 7,700 claims to Medicaid for services provided at Measures of Affect Theoretically Relative locations between March 2019 and June 2022. In total, more than $12.9 million of Medicaid funds were paid to the company.
"None of these services would have been paid if the Utah Medicaid program had known that services had been provided by unqualified individuals and that falsified information had been entered into medical records by Simiskey and others," a statement from the Utah Attorney General's Office says.
While investigating this fraud, it was discovered Simiskey had failed to file some personal tax returns and misstated her income on others. She also received public assistance benefits by improperly reporting her employment and income at Measures of Affect Theoretically Relative.
"In reality, Simiskey was the second-highest-paid worker at (Measures of Affect Theoretically Relative), receiving compensation of over $1.7 million from January 2019 through July 2022, all while she was receiving public assistance benefits and failing to pay required taxes," the statement said.
Kaye Lynn Wootton, director of the Medicaid Fraud Division, said this type of fraud wastes taxpayer money and limits resources for the "most needy individuals" in the state.
"When fraud like this occurs, Medicaid recipients do not receive the services they need. Many of the patients in this case were court-ordered to receive substance abuse treatment, but unbeknownst to judges and probation officers, they did not receive services from qualified providers," Wootton said.
