Cambria woman guilty in health care fraud case

Mayko enters plea in scheme to defraud Medicare, HHS

HARRISBURG -- A Cambria County woman pleaded guilty Wednesday to conspiracy to commit health care fraud for defrauding Medicare and the U.S. Department of Health and Human Services between 2017 and 2019.

Florentina Mayko, 39, entered the plea before U.S. Magistrate Judge Martin C. Carlson of the Middle District of Pennsylvania.

Mayko had been charged on May 9, 2023.

According to U.S. Attorney Gerard M. Karam, Mayko agreed with others to defraud Medicare by submitting medically unnecessary urine drug tests for chronic opioid patients at medical clinics where she was the chief executive officer, including a group of clinics known as Pain Medicine of York or PMY (also known as All Better Wellness).

Mayko became the CEO of Pain Medicine of York around January 2018. Prior to that, Mayko served as director of operations of a group of medical practices identified in the information as "Practice Group 1." Mayko was hired to work at Practice Group 1 by an individual identified as Physician 1. The owner of PMY was friends and business partners with Physician 1. Physician 1 was imprisoned for health care fraud and federal tax offenses in mid-2017, at which point the operation of Practice Group 1 was transitioned to PMY, Karam said.

When Mayko was promoted to the position of CEO of PMY, she was in charge of the day-to-day management of PMY's operations, which included the practices previously associated with Practice Group 1. PMY had a practice, established in 2016 by Physician 1 and PMY owner, of ordering multiple urine drug tests for each patient at every PMY office visit, despite a lack of medical necessity. From mid-2017 onward, Mayko and PMY owner were repeatedly confronted with information regarding the unlawful nature of the company's drug-test billing practices but continued to utilize the practice until search warrants were executed at PMY's various locations in November 2019.

PMY ceased operations soon thereafter because it could no longer retain medical providers. PMY billed Medicare for more than $10 million in urine drug tests from mid-2017 through the end of 2019, and Medicare paid out over $4 million for these urine drug tests.

The urine drug tests ordered by PMY were sent to an in-house laboratory at PMY whenever possible, Karam said. As a result, when medically unnecessary tests were billed to Medicare, the proceeds from them went to PMY itself. A large portion of these proceeds went to PMY owner and Mayko. Mayko, in turn, purchased several investment properties using these funds.

Mayko agreed to pay $1,408,976 in restitution. She also agreed to forfeit several properties in Ocean City, Md., and Myrtle Beach, S.C.