Pennsylvania woman charged by DOJ for defrauding Medicare

CAMBRIA COUNTY, Pa (WTAJ) — A Cambria County woman has been charged with conspiracy to commit health care fraud, according to the Department of Justice (DOJ).

The United States Attorney’s Office for the Middle District of Pennsylvania announced Thursday, May 11 that Florentina Mayko, 39, is accused of committing health care fraud for allegedly defrauding Medicare and the U.S. Department of Health and Human Services between 2017 and 2019.

Gerard M. Karam, United States Attorney, said the information they obtained alleges that Mayko agreed with others to defraud Medicare by submitting medically unnecessary urine drug tests for chronic opioid patients at medical clinics while she served as chief executive officer (CEO). This also included a group of clinics known as Pain Medicine of York (PMY) or also known as Better Wellness.

In January 2018, Mayko became the CEO of Pain Medicine of York. Prior to this, she was the Director of Operations of a group of medical practices known as “Practice Group 1” according to the DOJ.

Based on the information the DOJ received on “Practice Group 1” they learned that Makyo was hired by a person known as “Physician 1” who was charged with health care fraud and federal tax offenses in 2017. Investigators were made aware that “Physician 1” and the owner of PMY were friends.

Following the arrest of “Physician 1,” “Practice Group 1” transitioned to PMY and Mayko was promoted to CEO, managing day-to-day operations. According to the DOJ, in 2016 “Physician 1” and the owner of PMY collaborated to order the urine drug test for each patient at every PMY office visit. From mid-2017 onwards, Mayko and the owner of PMY were repeatedly confronted with information regarding the “unlawful” nature of the company’s billing practices but continued to do so until a search warrant was executed in 2019. PMY ceased operations soon after.

It is alleged that PMY billed Medicare for more than $10 million in urine drug tests from mid-2017 through the end of 2019. Medicare paid out over $4 million for these urine drug tests and the proceeds went straight to PMY, according to the DOJ.

Mayko could receive up to 10 years of jail time if convicted along with a term of supervised release and a fine.