Medical Biller Faces Decades in Jail for Healthcare Fraud, Identity Theft, and Tax Offenses

A medical biller in the Tampa Bay area of Florida has pleaded guilty to four counts of healthcare fraud, four counts of aggravated identity theft, two counts of failing to file a tax return, and one count of filing a false tax return.

Joshua Maywalt, 40, of Tampa, worked as a medical biller at a Clearwater company that provided credentialing and medical billing services to a range of healthcare provider clients in Florida. In his capacity as a medical biller, Maywalt was able to access the company’s financial, medical provider, and patient information.

Maywalt was assigned to a Tampa Bay area physician’s account and submitted claims to Florida Medicaid HMOs for services provided by that physician to recipients of Medicaid. Maywalt wrongfully accessed the company’s patient information and used the name and identification number of the physician to submit false and fraudulent claims to a Florida Medicaid HMO for services that Maywalt claimed were provided by the physician when they had not been. The “pay to” information on the claims for the fictitious medical services was changed to account numbers under Maywalt’s control.

In the tax years of 2017 and 2018, Maywalt failed to file a tax return with the Internal Revenue Service and filed a false tax return for the 2019 tax in which he substantially underreported his income as he did not include the amounts he paid into his bank accounts from his fraudulent billing activities.

According to the United States Attorney’s Office, Middle District of Florida, Maywalt will forfeit $2.2 million in funds and real estate property that are directly traceable to his offenses. He now faces a maximum jail term of 53 years – 10 years for each healthcare fraud count, up to 3 years for filing a false tax return, up to 2 years for each count of a failure to file a tax return and a mandatory 2 years for each count of aggravated identity theft. The aggravated identity theft sentences will run consecutively.

The 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.

Author: Steve Alder has many years of experience as a journalist, and comes from a background in market research. He is a specialist on legal and regulatory affairs, and has several years of experience writing about HIPAA. Steve holds a B.Sc. from the University of Liverpool.