Tampa Bay Medical Biller Sentenced For Healthcare Fraud, Aggravated Identity Theft, And Tax Offenses
Tampa, Florida – U.S. District Judge Mary S. Scriven has sentenced Joshua Maywalt (42, Tampa) to five years and five months in federal prison for healthcare fraud, aggravated identity theft, filing a false income tax return, and failing to file an income tax return. As part of his sentence, the court also entered an order forfeiting $2,257,029.86 and real property located at 5346 Northdale Boulevard in Tampa, which are traceable to proceeds of the offense. Maywalt had pleaded guilty on December 1, 2021.
According to court documents, Maywalt worked as a medical biller at a company in Clearwater that provided credentialing and medical billing services for its medical provider clients. In this capacity, Maywalt had access to the company’s financial, medical provider, and patient information. Maywalt was assigned to a Tampa Bay area physician’s account (“Physician #1”) and was responsible for submitting claims to Florida Medicaid Health Maintenance Organizations (HMO) for services rendered by Physician #1 to Medicaid recipients.
Maywalt abused his role as a medical biller by wrongfully accessing and utilizing the company’s patient information and Physician #1’s name and identification number to submit false and fraudulent claims to a Florida Medicaid HMO for medical services purportedly rendered by Physician #1, which were not actually rendered. Maywalt also altered the “pay to” information associated with the HMO’s payment processor so that the payments for the non-rendered medical services were sent to bank accounts under Maywalt’s control.
Maywalt knowingly signed and filed a false federal income tax return for tax year 2019 which substantially understated his income and reported only his employment wages, and not the substantial amount of money he was depositing into his bank accounts as a result of his fraudulent activities. In addition, Maywalt failed to file federal income tax returns for 2017 and 2018, as required by the Internal Revenue Service.
“Health care industry professionals are required to follow Medicaid rules and accurately bill for services that are actually provided. Fraudulently billing Medicaid for personal gain cheats millions of people who fund the program and contributes to the soaring cost of health care,” stated Omar Perez Aybar, Special Agent in Charge with the Department of Health and Human Services, Office of Inspector General. “Working closely with our law enforcement partners, we will continue to pursue those who exploit government health care programs.”
“Joshua Maywalt had no concern for anyone except himself. He exploited the personal information of medical patients, fraudulently billed services on behalf of a local physician and then cheated the U.S. tax system for his own personal gain,” said Brian Payne, special agent in charge of the IRS-CI Tampa Field Office. “In the end, committing fraud doesn’t pay. In this case, it resulted in a five-year prison sentence and a multimillion dollar forfeiture order.”
This case was investigated by the Department of Health and Human Services -Office of Inspector General, the Federal Bureau of Investigation, the Florida Medicaid Fraud Control Unit, Office of the Florida Attorney General, and the Internal Revenue Service – Criminal Investigation. It was prosecuted by Assistant United States Attorneys Maria Guzman and Suzanne Nebesky.