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A Not So Civilized Divorce

A Not So Civilized Divorce

Healthcare-8
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

The film The War of the Roses follows a wealthy couple with a seemingly perfect marriage that turns into an outrageous and bitter divorce battle. The film is peppered throughout with brilliant quotes from actor Danny DeVito serving as the movie’s narrator. He starts the film by saying of the couple, “They met great, they agreed on that, but the way I saw it, the bastards never had a chance.” The same description could also be applied to the Le Farmer’s of Texas. These two didn’t have a chance once Kay Le Farmer started a scheme to steal almost a half a million from Medicaid using her husband’s identity without him knowing it.

Kay Le Farmer worked for her husband’s psychotherapy practice as an office manager beginning in 2009. She was tasked with scheduling patient visits, billing insurance companies and maintaining enrollment in Medicaid and Amerigroup, according to her plea agreement. She had access to patient information, billing information and her husband’s credentials.

The words of the Danny DeVito’s character ring true again: “A civilized divorce is a contradiction in terms.” Starting in 2013, the year they separated, the newly unemployed Kay began submitting fraudulent claims to Medicaid using her soon to be ex-husbands provider number. She submitted 434 fake claims between January 2013 and September 2017. Kay got a new job as an office manager for a pediatrician in 2017, but that didn’t stop her fraud. From November 2017 to March 2018, Kay submitted bogus Medicaid claims for 25 patients associated with the pediatrician. But in those claims, she said the patients received psychotherapy services from her ex. Unfortunately for Kay, her ex-husband no longer practiced therapy and her scheme to steal from Medicaid came to an end.

Great job by the Department of Health and Human Services in stopping the revenge of Kay Le France.

Today’s Fraud of The Day is based on article “Texas Therapist’s ex-wife uses his provider number to submit $617,983 in fake claims, feds say” published by The Star Telegram on March 23, 2023

After separating from her husband who worked as a therapist, a Texas woman began defrauding Medicaid using his provider number, authorities said. Now the 47-year-old woman has pleaded guilty to health care fraud, according to a March 22 news release from the U.S. Attorney’s Office for the Southern District of Texas. Authorities said the woman, who lived in Katy, worked for her spouse’s business as an office manager from about 2009 until 2013, the same year they separated. The couple divorced in 2014.

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