On Tuesday, October 21, 2025, Lillian Kaye Simiskey was sentenced to 364 days in jail and ordered to pay restitution in the amount of $2,698,488.95 by Judge Chelsea Koch in the Third District Court. Simiskey pleaded guilty to one count of Pattern of Unlawful Activity for violations of the Utah False Claims Act per Utah Code §26B-3-1101, a second-degree felony, one count of Tax Evasion per Utah Code §76-8-1101(1)(d)(i), a third-degree felony, and one count of Public Assistance Fraud per Utah Code §76-8-1206, a third-degree felony. A restitution hearing is scheduled for January 13, 2026, to evaluate Simiskey’s financial declaration and establish a payment schedule.
In February 2021, the Department of Health and Human Services, Licensing Division, referred a case to the Medicaid Fraud and Patient Abuse Division (Medicaid Fraud Division) at the Office of the Utah Attorney General (OAG) including allegations that a Medicaid provider, Measures of Affect Theoretically Relative (MATR), had submitted claims to Medicaid for services which were not provided by qualified professionals and were documented in a fraudulent manner. MATR was a behavioral health company offering substance use disorder treatment. MATR had a residential treatment center in Mt. Pleasant and multiple offices in other areas of the State.
Simiskey was a member of the board and administrator within MATR. She, along with two other individuals, was responsible for submitting claims to Medicaid for services allegedly provided in all MATR locations. In total, over 7,700 claims were submitted to Medicaid throughout the period of March 11, 2019, through June 8, 2022, resulting in Medicaid funds in the amount of over $12.9 million being paid to MATR. 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.
The Medicaid Fraud Division’s investigation also identified evidence of tax fraud and public assistance fraud. Simiskey evaded State tax liabilities by failing to file some personal tax returns and misstating her income on others. For these offenses, Simiskey was ordered to pay restitution of $59,044.00. Additionally, Simiskey received public assistance benefits for herself by failing to properly report her employment and income from MATR, resulting in a loss amount of $39,444.95. In reality, Simiskey was the second highest paid worker at MATR, 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 Medicaid Fraud Division of the OAG filed charges against Simiskey in March 2024.
Simiskey will 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.
Medicaid is a joint federal-state program that provides health coverage for low-income individuals and families. Medicaid is funded by a partnership between the federal government and state governments, primarily using taxpayer dollars.
“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,” Kaye Lynn Wootton, Director of the Medicaid Fraud Division, said. “Additionally, Medicaid fraud wastes taxpayer money and limits the resources available for some of the most needy individuals in our State.”
Kaye Lynn Wootton and her team of investigators, auditors, nurses, attorneys, paralegals and support staff work diligently to hold those who commit Medicaid fraud accountable and to investigate and prosecute the abuse, neglect, and exploitation of vulnerable individuals. This mission would not be possible without the work of numerous State and Federal partners. This case required support from investigators at the Utah State Tax Commission and Department of Workforce Services and the Assistant Attorneys General who support them, policy experts at Utah’s Department of Health and Human Services (DHHS), agents from the federal DHHS – Office of Inspector General, ongoing support from the Utah Medicaid program (Division of Integrated Healthcare), and the Utah Office of Inspector General of Medicaid Services.
The Medicaid Fraud and Patient Abuse Division of the Office of the Utah Attorney General receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $3,984,304 for federal fiscal year 2026. The State of Utah funds the remaining 25 percent.
