Ex-Wife’s 56 Month Sentence For Using Ex-Husband’s Provider Number To Commit Medicaid Fraud Warning To Other Providers |

Ex-Wife’s 56 Month Sentence For Using Ex-Husband’s Provider Number To Commit Medicaid Fraud Warning To Other Providers

The November 13th sentencing of a Katy, Texas woman to 56 months imprisonment for using her ex-husband’s provider number to defraud Medicaid of more than $600,000 reminds physicians and other health care providers of the need for careful oversight and diligence of all workers including family and friends.

Kay Le Farmer Farmer is the former office manager for her ex-husband – a therapist and Medicaid provider in the Houston area. Following their separation, Farmer pleaded guilty on March 22, 2023 to using her ex-husband’s provider number to submit fraudulent claims to Medicaid, unbeknownst to him, for counseling services that were never provided as well as to other frauds.

Hearing testimony revealed Farmer fraudulently obtained information of over 300 patients, her attempts to lie and cover-up her crimes and that she appeared to be searching for more employment opportunities to steal more information.

In 2017, Farmer admitted to using her employment at a pediatrician’s office to obtain patient information. She then submitted more fraudulent claims to Medicaid under her ex-husband’s provider number. In total, from 2013 until 2018, Farmer submitted, or caused the submission of, approximately $617,983.86 in claims for psychotherapy services that were not provided. Farmer admitted she was paid approximately $432,924.69 on those claims.

For these crimes, U.S. District Judge George C. Hanks ordered Farmer to serve 56 months in federal prison followed by two years of supervised release.

The conviction and sentencing warns other providers to remain vigilant in overseeing office managers and other workers with access to sensitive information and responsibilities including family or friends presumed trustworthy. Providers also should endure all staff including themselves, family and friends are included in required checks for status as disqualified persons and other credentials confirmations.

Providers that suspect or discover fraud or other suspicious conduct by members of their team should contact qualified legal counsel for assistance investigating and redressing concerns. Ideally, providers should seek to avoid making unprivileged statements or engaging in potentially sensitive discussions about these concerns or events until obtaining legal representation to minimize the risk those statements might undermine or complicate the defensibility of their actions.

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We hope this update is helpful. For more information about these or other health or other legal, management or public policy developments, please contact the author Cynthia Marcotte Stamer via e-mail or via telephone at (214) 452 -8297.

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About the Author

Recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: ERISA & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, Cynthia Marcotte Stamer is a practicing attorney board certified in labor and employment law by the Texas Board of Legal Specialization and management consultant, author, public policy advocate and lecturer widely known for 35 plus years of health industry and other management work, public policy leadership and advocacy, coaching, teachings, and publications.

A Fellow in the American College of Employee Benefit Counsel, Co-Chair of the American Bar Association (“ABA”) International Section Life Sciences and Health Committee and VIce-Chair Elect of its International Employment Law Committee, Chair-Elect of the ABA TIPS Section Medicine & Law Committee, Past Chair of the ABA Managed Care & Insurance Interest Group, Scribe for the ABA JCEB Annual Agency Meeting with HHS-OCR, past chair of the ABA RPTE Employee Benefits & Other Compensation Group and current co-Chair of its Welfare Benefit Committee, and Chair of the ABA Intellectual Property Section Law Practice Management Committee, Ms. Stamer is most widely recognized for her decades of pragmatic, leading-edge work, scholarship and thought leadership on healthcare and life science, managed care and insurance and other workforce and staffing, employee benefits, safety, contracting, quality assurance, compliance and risk management, and other legal, public policy and operational concerns in the healthcare and life sciences, employee benefits, managed care and insurance, technology and other related industries. She speaks and publishes extensively on these and other related compliance issues.

Ms. Stamer’s work throughout her career has focused heavily on working with health care and managed care, life sciences, health and other employee benefit plan, insurance and financial services and other public and private organizations and their technology, data, and other service providers and advisors domestically and internationally with legal and operational compliance and risk management, performance and workforce management, regulatory and public policy and other legal and operational concerns. Scribe for the ABA JCEB Annual Meeting with the HHS Office of Civil Rights, her experience includes extensive involvement throughout her career in advising health care and life sciences and other clients about preventing, investigating and defending EEOC, DOJ, OFCCP and other Civil Rights Act, Section 1557 and other HHS, HUD, banking, and other federal and state discrimination investigations, audits, lawsuits and other enforcement actions as well as advocacy before Congress and regulators regarding federal and state equal opportunity, equity and other laws.

For more information about Ms. Stamer or her health industry and other experience and involvements, see www.cynthiastamer.com or contact Ms. Stamer via telephone at (214) 452-8297 or via e-mail here.

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This entry was posted on Friday, November 17th, 2023 at 9:15 pm and is filed under Employer, Employment law, Health Care, Health Care Finance, Health Care Fraud, Health Care Provider. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.