New Mexico AG Sues Over $1.6M Medicaid Fraud and Identity Theft
Summary
New Mexico Attorney General Raúl Torrez has filed a lawsuit against two operators of a nonprofit afterschool program, Kids in Need of Support Services (KISS), for allegedly defrauding Medicaid of over $1.6 million and committing identity theft. The lawsuit details 91 counts of fraud and identity theft, including the fraudulent submission of claims for services never rendered and the misuse of children's social security numbers.
What changed
The New Mexico Attorney General's office has filed a civil lawsuit against Susanne Kee and Bethanne Kee-Medran, operators of the Kids in Need of Support Services (KISS) nonprofit afterschool program in Silver City. The complaint alleges a scheme to defraud Medicaid of at least $1,626,496 through fraudulent claims for services never rendered. Additionally, the defendants are accused of identity theft, illegally using social security numbers and Medicaid identifiers of children and adults without consent, and fabricating psychological disorders to justify services, thereby creating false medical records.
This enforcement action carries significant implications for compliance officers in healthcare and nonprofit sectors. The lawsuit seeks restitution, fines, and penalties. Regulated entities should note the severity of charges, including fraud and identity theft, and the potential long-term harm to victims from falsified medical records. While no specific compliance deadline is mentioned for other entities, this case highlights the critical need for robust internal controls over billing, patient data, and program service delivery to prevent similar fraudulent activities and potential regulatory scrutiny.
What to do next
- Review internal controls for Medicaid billing and service verification.
- Ensure strict adherence to patient consent and data privacy protocols for all patient identifiers.
- Assess program operations for potential conflicts of interest and fraudulent practices.
Penalties
Restitution, fines, and penalties
Source document (simplified)
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Attorney General Raúl Torrez Files Lawsuit Alleging Over $1.6 Million in Fraudulent Medicaid Claims and Identity Theft of Children
- August 14, 2025
Silver City, NM – The New Mexico Department of Justice and its Medicaid Fraud and Elder Abuse Bureau have filed a lawsuit against two operators of Kids in Need of Support Services (KISS), a nonprofit afterschool program in Silver City, for a combined 91 counts of fraud and identity theft. The complaint alleges that program operators Susanne Kee and Bethanne Kee-Medran knowingly submitted at least $1,626,496 in fraudulent Medicaid claims for services that were never rendered while illegally using both adult and children’s social security numbers, falsely representing psychological disorders and more.
“The defendants in this case have been taking advantage of a system meant to help those in need, stealing social security numbers of children in their care and fabricating psychological disorders for these children in a scheme to defraud taxpayers,” said Attorney General Raúl Torrez. “Their actions not only resulted in the theft of public funds, but it will likely require the affected children and their families to spend substantial time and resources to correct falsified medical records that could impact future employment. We intend to hold these bad actors accountable for harming the children in their care and will do everything in our power to assist victims and their families for the harm that has been caused by this criminal enterprise.”
As part of the Medicaid fraud scheme, the NMDOJ’s investigation uncovered that the pair not only submitted fraudulent claims for services to children that were never rendered, but also:
- Illegally utilized patient social security numbers of children and adults without knowledge or consent of victims or their parent/guardians
- Illegally utilized Medicaid identifier numbers of children and adults without knowledge or consent of victims or their parent/guardians
- Documented false psychological disorders to justify the ‘services’ – disorders that create fictitious health records that will follow and have a potentially-negative impact on the victims throughout their lives Kee is charged with 10 counts of fraud and 36 counts of identity theft while Kee-Medran is charged with nine counts of fraud and 36 counts of identity theft. The NMDOJ is seeking restitution, fines and penalties in the lawsuit.
Criminal Complaint and Affidavit – Susanne Kee
Criminal Complaint and Affidavit – Bethanne Kee-Medran
These complaints have been filed with the Magistrate Court in Silver City. The Court will schedule the defendants’ arraignments at a future date.
This case was investigated by the NMDOJ’s Medicaid Fraud and Elder Abuse Bureau (MFEAB). The New Mexico MFEAB receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $3,451,202 for federal fiscal year 2025. The remaining 25 percent, totaling $1,150,401 for fiscal year 2025, is funded by the State of New Mexico.
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