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Tampa Bay Medical Biller Charged with Health Care Fraud, Aggravated Identity Theft

pexels-karolina-grabowska-4386466-300x200The U.S. Attorney’s Office for the Middle District of Florida has announced charges against a Tampa medical biller accused of using his position to fraudulently bill Medicaid for millions of dollars worth of services that were never provided.

Joshua Maywalt, 40, is charged with four counts of health care fraud and four counts of aggravated identity theft. Attorney information was not available at the time of writing.

The accused from Tampa was allegedly a medical biller at an unnamed local company that provided medical billing and credentialing services to healthcare providers. His position reportedly gave him access to data about healthcare providers and their patients.

The indictment claims that he was assigned to handle the account of a physician in Tampa Bay. He was responsible for submitting claims to state health maintenance organizations (HMOs) for services rendered by the physician to Medicaid recipients. The Medicaid biller is accused of abusing his role by wrongfully accessing and using patient information, as well as the physician’s name and ID number, to submit false and fraudulent claims to an HMO for medical services that were never provided by the physician. He also allegedly altered the “pay to” information associated with the HMO’s payment processor so that the payments for those services were sent to his bank accounts.

In addition to the fraud and identity theft charges, the indictment also announced the forfeiture of $2.2 million and real estate property located at 5346 Northdale Boulevard in Tampa, which are the traceable proceeds of the alleged offense.

If convicted, the accused faces a maximum penalty of 10 years in prison for each of the health care fraud counts and up to two years in prison for each of the aggravated identity theft counts. The U.S. Attorney’s office press release noted that an indictment is merely a formal charge that a defendant has violated federal criminal law. The defendant is presumed innocent unless proven guilty in court.

The Medicaid program is funded by both state and federal tax dollars. It is designed to pay for health care for low-income and vulnerable Floridians. Medicaid fraud means the intentional misrepresentation or deception by a healthcare provider, biller, or Medicaid recipient with the knowledge that the deception could result in some personal benefit.

South Florida has for decades been known as the nation’s healthcare fraud capital, so it’s unsurprising that a large number of these types of cases occur in the Sunshine State. In recent years, the government has been casting a wide net to capture fraudsters, and it’s easy for innocent medical billers to get caught and face charges that carry severe penalties.

Federal prosecutors often act quickly to prosecute cases of Medicaid or Medicare fraud, which means that if you are accused of wrongdoing, you should also act fast by immediately seeking legal representation. A good attorney can determine the scope and nature of the allegations against you and help you to mount an effective defense.

South Florida Fraud Defense Attorney

Are you accused of committing health care fraud in South Florida? Contact Brian Silber, P.A. to set up a free initial consultation with one of South Florida’s most experienced fraud defense attorneys.

Source: 11.20.20 Tampa Bay area medical biller indicted on health care fraud and aggravated identity theft charges.pdf

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