Bills, Bills, Bills 

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A Tampa, Fla, man faces years in prison and a hefty restitution fee for a slew of charges, including healthcare fraud, identity theft, and tax fraud. (This fraudster was a very busy guy.) Joshua Maywalt, 40, was involved in a healthcare fraud scheme where he abused his credentials to submit fraudulent medical claims and deposited the reimbursements received into his own bank account.

Maywalt worked as a medical biller at a Clearwater company that provided credentialing and medical billing services to its medical provider clients. With this role, Maywalt had the ability to access (and take advantage of) the company’s financial, medical provider, and patient information. During his employment, Maywalt was assigned to a local physician’s account (Physician #1). His responsibility was to submit claims to Florida Medicaid HMOs for services rendered to Medicaid recipients by Physician #1.

He not only used his access to steal patients’ personal information, but he also exploited Physician #1’s name and ID numberHe used this combo to submit fraudulent claims to a Florida Medicaid HMO, stating that Physician #1 had rendered these fictitious services. Maywalt then altered the “pay to” information associated with those claims, sending the fabricated medical service payments to his own bank account.

In case this story isn’t juicy enough yet, I’ll let you in on a spoiler. Healthcare fraud was only the beginning for Maywalt. In addition to his involvement in a healthcare conspiracy, Maywalt also knowingly signed and filed a false federal income tax return in 2019(completely omitting the vast amount of money he was making from his “side-gig”). 

Maywalt plead 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(That’s a lot.) When sentenced, 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. On top of that, Maywalt will also be required to forfeit $2.2 million in funds and property. (Unfortnately for Maywalt, these were all traceable to the money he made from this scheme.)

Today’s Fraud of the Day comes from an article, “Tampa Bay Area Medical Biller Pleads Guilty To Healthcare Fraud, Aggravated Identity Theft, And Tax Offenses,” published by the United States Attorney’s Office (Middle District of Florida) on December 3, 2021.

Tampa, Florida – 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.

 

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.