Tampa Bay Area Medical Biller Pleads Guilty To Healthcare Fraud, Aggravated Identity Theft, And Tax Offenses
The following is an update to a case previously noted on DataBreaches.net when the defendant was first indicted.
Joshua Maywalt (40, Tampa) has pleaded guilty to four counts of healthcare fraud, four counts of aggravated identity theft, one count of filing a false federal income tax return, and two counts of failing to file federal income tax returns. He faces a maximum penalty of 10 years in federal prison for each healthcare fraud count, a 2-year mandatory consecutive sentence on the aggravated identity theft counts, a maximum penalty of 3 years for filing a false income tax return, and a up to 2 years for each failure to file an income tax return offense. Through the superseding information, the United States also notified Maywalt that it intends to forfeit $2.2 million in funds and real property located at 5346 Northdale Boulevard, in Tampa, all of which are traceable to proceeds of his offenses.
According to court documents, Maywalt was a medical biller at a Clearwater company that furnished credentialing and medical billing services to its medical provider clients. In that capacity, Maywalt was able to access and utilize 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 HMOs 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, and using those to submit false and fraudulent claims to a Florida Medicaid HMO for medical services purportedly, but not actually, rendered by Physician #1. Maywalt then altered the “pay to” information associated with those claims so that the payments for the fictitious medical services were sent to bank accounts under his control.
Maywalt knowingly signed and filed a false federal income tax return for tax year 2019, substantially understating his income by reporting only his employment wages and not the substantial amounts 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.
This case was investigated by the Department of Health and Human Services – Office of the Inspector General, the Federal Bureau of Investigation, the Florida Attorney General’s Medicaid Fraud Control Unit, and the Internal Revenue Service – Criminal Investigation. It is being prosecuted by Assistant United States Attorneys Maria Guzman and Suzanne Nebesky.