PORTLAND — A judge on Wednesday sentenced the owner of a counseling agency in Lewiston convicted on multiple counts of felony welfare fraud to 3½ years in federal prison.

Federal investigators converge on the office of Facing Change in Lewiston in 2018. Andree Kehn/Sun Journal file photo

Nancy Ludwig, 65, of Winthrop was ordered to repay MaineCare, Maine’s Medicaid program, more than $660,000 in restitution.

She owned the now-defunct Facing Change mental health and substance abuse counseling agency on Park Street in downtown Lewiston. A jury convicted her after a five-day trial in federal court in June on nine counts of health care fraud conspiracy, paying kickbacks, using fraudulent medical documents and obstructing an audit. The jury took less than two hours to deliberate.

Ludwig appeared Wednesday in U.S. District Court clad in a black dress and blue jacket. She has been free on personal recognizance.

U.S. District Court Judge Jon Levy ordered Ludwig to surrender to U.S. Marshals Service on March 4 to begin serving her sentence. After her release from prison, she will be on probation for three years, Levy said.

According to trial testimony, Ludwig conspired with a Somali interpreter and others to commit health care fraud.


Prosecutors presented evidence at trial showing that beginning in February 2015, Ludwig agreed to pay interpreter Abdirashid Ahmed kickbacks in return for Ahmed bringing MaineCare beneficiaries clients to Facing Change. Ahmed and other Facing Change workers submitted false claims to MaineCare for counseling and interpreter services, according to court records.

In 2016, in response to a MaineCare regulatory change, Ludwig and Ahmed conspired to change the diagnosis of many Facing Change clients who suffered from post-traumatic stress disorder to schizophrenia so they could remain eligible to receive MaineCare (Maine’s Medicaid) reimbursement for services at Facing Change. That same year, auditors with the MaineCare Program Integrity Unit audited Facing Change.

Ludwig and many of her employees conspired to manufacture false records in an attempt to deceive the auditor, prosecutors argued at trial. The fraud continued until May 1, 2018, when federal and state agents executed search warrants at Facing Change and Ahmed’s business, according to court records.

In May, Ahmed pleaded guilty to conspiring to commit health care fraud. Garat Osman, another interpreter, pleaded guilty in May to a felony charge of conspiracy to commit health care fraud. They have not been sentenced.

Four other people connected to this case have been convicted of federal health care felonies, including Ludwig’s son, Jared Lemieux. He pleaded guilty to conspiracy to commit offense against the United States in the form of paying kickbacks. He was sentenced to probation for one year.

Two additional defendants agreed to civil settlements.


“This was a widespread fraud,” Levy said.

Ludwig told Judge Levy on Wednesday that she was remorseful for her actions, but claimed she merely exercised poor judgment and negligence in not providing the proper oversight of her staff.
She characterized kickbacks paid to Ahmed as bonuses.

But Levy said Ludwig knew what she was doing when she entered into the agreement with Ahmed and paid him kickbacks for more than a year. He said he saw “no evidence” that she had been “coerced” into that relationship, as Ludwig’s attorney, Roger Brunelle, implied.

Her rediagnosing of nearly two dozen patients to ensure continued payment from MaineCare is “not a product of good intentions gone awry,” as she had asserted, Levy said.

As the sole owner of Facing Change, she was aware of a “systematic and concerted effort to defraud MaineCare” through overbilling, Levy said.

He said Ludwig had “shown some acceptance of responsibility” and “demonstrated some remorse for her actions,” but not enough to warrant a lessening of her sentence under federal guidelines.


Under those guidelines, Levy said the range of her sentence should have been from 63 to 78 months.

He noted she and her co-conspirators ended up “taking advantage of the very people they were supposed to be helping.”

Because of her actions, Levy said, the lives of her clients have been adversely affected and some members of her staff, including her son, will “go through life with the black mark” of a federal criminal conviction.

But Levy also noted that Ludwig was not a typical criminal defendant. A lifelong resident of Maine, she owned and operated a mental health counseling service for nearly 30 years, helping people cope with various mental illness and substance abuse issues.

She earned a master’s degree in social work, and she has no criminal history and no history of professional discipline, he said.

“Throughout your career, you have positively touch the lives of many people,” he said.

Now that she has closed her business and surrendered her counseling license, Levy said he hoped Ludwig might use her higher education and decades of experience for good again.

“This need not be the final chapter of your life. That remains to be written,” Levy said.

“After rehabilitating yourself,” he said, “you have the potential to make a unique contribution moving forward.”

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