Tampa, Fla. — U.S. District Judge Mary S. Scriven sentenced Joshua Maywalt (42, Tampa) to five years and five months in federal prison for health care fraud, aggravated identity theft, production of a false tax return and failure to file a tax return. tax return. As part of his sentence, the court also issued an order of forfeiture of $2,257,029.86 and real estate located at 5346 Northdale Boulevard in Tampa, which are allocable to the proceeds of the offense. Maywalt had pleaded guilty on December 1, 2021.

According to court documents, Maywalt worked as a medical biller at a Clearwater company that provided accreditation and medical billing services to its medical provider clients. In this capacity, Maywalt had access to the company’s financial, medical and patient information. Maywalt was assigned to the account of a Tampa Bay-area physician (“Physician #1”) and was responsible for submitting claims to Florida Medicaid Health Maintenance Organizations (HMOs) for services rendered by the #1 physician to Medicaid recipients.

Maywalt abused his role as a medical biller by improperly accessing and using the company’s patient information and the name and ID number of the #1 physician to submit false and fraudulent claims to an HMO Medicaid of Florida for medical services allegedly rendered by Doctor #1, which were not actually rendered. Maywalt also changed the “pay to” information associated with the HMO’s payment processor so that payments for unrendered medical services are sent to bank accounts under Maywalt’s control.

Maywalt knowingly signed and filed a false federal income tax return for the 2019 tax year that significantly understated his income and only reported his employment salary, not the substantial amount of money he deposited on his bank accounts as a result of his fraudulent activities. Additionally, Maywalt did not file federal income tax returns for 2017 and 2018, as required by the Internal Revenue Service.

“Healthcare industry professionals are required to follow Medicaid rules and accurately bill for services actually provided. Fraudulent Medicaid billing for personal gain deceives millions of people who fund the program and contributes to soaring health care costs,” said Omar Perez Aybar, Special Agent in Charge of the Department of Health and Human Services, Office of the Inspector General. “Working closely with our law enforcement partners, we will continue to prosecute those who exploit government health care programs.”

“Joshua Maywalt cared about no one but himself. He exploited medical patients’ personal information, fraudulently billed services on behalf of a local doctor, and then cheated the US tax system for his own gain. personnel,” said Brian Payne, special agent in charge of the IRS-CI field office in Tampa. “At the end of the day, committing fraud doesn’t pay. In this case, it resulted in a five-year sentence. jail and a multi-million dollar forfeiture order.

This matter was investigated by the Department of Health and Human Services – Office of Inspector General, Federal Bureau of Investigation, Florida Medicaid Fraud Enforcement Unit, Attorney’s Office General of Florida and the Internal Revenue Service – Criminal Investigation. He was prosecuted by Assistant United States Attorneys Maria Guzman and Suzanne Nebesky.