Elma Myles, Medicaid and IRS Fraud, Maryland 2016

Baltimore, Maryland – A 52-year-old Baltimore resident has pleaded guilty to health care fraud in connection with schemes to defraud Medicaid and other health benefit programs; aggravated identity theft; and conspiracy to defraud the IRS by not reporting income from the health care fraud scheme.

Elma Myles, age 52, of Baltimore pleaded guilty to the charges on December 19, 2016, in the United States District Court for the District of Maryland. The guilty plea was announced by United States Attorney for the District of Maryland Rod J. Rosenstein; Special Agent in Charge Nicholas DiGiulio, Office of Investigations, Office of Inspector General of the Department of Health and Human Services; Acting Special Agent in Charge Thomas J. Holloman of the Internal Revenue Service – Criminal Investigation, Washington, D.C. Field Office; and Chief James W. Johnson of the Baltimore County Police Department.

According to Myles’ plea agreement, she conspired with her co-defendant, Harry Crawford, who owned and operated RX Resources and Solutions (RXRS), a durable medical equipment provider located in Randallstown, Maryland. Myles worked at RXRS as a biller and admitted to conspiring to defraud Medicaid and other health benefit programs by having RXRS bill for supplies that were never provided, overcharge for materials actually delivered, and bill for supplies that were unneeded and had not been prescribed by a physician.

Myles and Crawford worked closely together, lived together, and were once domestic partners. Both were managers and supervisors of all business activities at RXRS. Myles and her co-conspirators used the personal identity information of clients to submit fraudulent claims to Medicaid and other health care benefits programs for disposable medical supplies that were not delivered to the beneficiary.

An analysis of RXRS billing of Medicaid from 2007 through 2014 establishes that the loss to Medicaid just for incontinence supplies billed but not provided is approximately $1.2 million. Myles admitted that she conspired to defraud the United States by not reporting or paying taxes on the proceeds of the fraud.

The IRS determined that Myles owes $40,194.36 in federal taxes and fines. Myles faces up to 20 years in prison and $500,000 in fines. Her sentencing is scheduled for a later date.

Myles’ crimes were uncovered after federal agents executed a search warrant at RXRS and Myles and Crawford’s home on February 4, 2014. Agents recovered almost $60,000 in cash from a clothes bin beside the bed in Crawford’s room. Myles had made a makeshift closet containing tens of thousands of dollars’ worth of clothing and designer shoes, including apparel for her then three-year-old granddaughter who competed in beauty pageants.

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