New Mexico Attorney General Files Lawsuit Against Non-Profit Over $1.6 Million in Medicaid Fraud and Identity Theft

Strategic Insights -

New Mexico Attorney General Raul Torrez has taken action against two operators of a non-profit afterschool program, alleging over $1.6 million in fraudulent Medicaid claims and identity theft of children. The lawsuit, filed by the New Mexico Department of Justice's Medicaid Fraud and Elder Abuse Bureau, accuses Susanne Kee and Bethanne Kee-Medran of knowingly submitting false claims for services that were never rendered, while illegally using adult and children's social security numbers to fabricate psychological disorders. The case highlights the exploitation of a system meant to help those in need, with the defendants allegedly stealing social security numbers and falsifying medical records that could impact future employment for the affected children.

Key Takeaways:

  • The lawsuit alleges 91 counts of fraud and identity theft against Susanne Kee and Bethanne Kee-Medran, operators of Kids in Need of Support Services (KISS) in Silver City, New Mexico.
  • The complaint alleges that the defendants submitted at least $1,626,496 in fraudulent Medicaid claims for services that were never rendered.
  • The investigation found that the pair illegally used patient social security numbers of children and adults without knowledge or consent.
  • Documented false psychological disorders to justify the 'services' that create fictitious health records with a potentially-negative impact on the victims throughout their lives.
  • Susanne Kee is charged with 10 counts of fraud and 36 counts of identity theft, while Bethanne Kee-Medran is charged with 9 counts of fraud and 36 counts of identity theft.
  • The New Mexico Department of Justice is seeking restitution, fines, and penalties in the lawsuit.
  • The case was investigated by the NMDOJ's Medicaid Fraud and Elder Abuse Bureau.
  • The New Mexico MFEAB receives 75 percent of its funding from the U.S. Department of Health and Human Services, with the remaining 25 percent funded by the State of New Mexico.

Statistics:

  • $1,626,496: The amount in fraudulent Medicaid claims submitted by the defendants.
  • 91: The number of counts of fraud and identity theft alleged against the defendants.
  • 10: The number of counts of fraud charged against Susanne Kee.
  • 36: The number of counts of identity theft charged against Susanne Kee.
  • 9: The number of counts of fraud charged against Bethanne Kee-Medran.
  • 36: The number of counts of identity theft charged against Bethanne Kee-Medran.
  • $3,451,202: The total funding received by the New Mexico MFEAB from the U.S. Department of Health and Human Services for federal fiscal year 2025.
  • $1,150,401: The amount of funding received by the New Mexico MFEAB from the State of New Mexico for federal fiscal year 2025.

Sources:

  • New Mexico Department of Justice press release, "Attorney General Raul Torrez Files Lawsuit Alleging Over $1.6 Million in Fraudulent Medicaid Claims and Identity Theft of Children", August 14.