A medical biller has been sentenced to 12 years in federal prison after being convicted in a massive insurance fraud scheme that involved posing as an NBA player and other patients to harangue the companies for payments that weren91裸聊视频檛 actually due, prosecutors said.
U.S. District Judge Joanna Seybert called Matthew James91裸聊视频� actions 91裸聊视频渋nexcusable91裸聊视频� as she sentenced him Friday in Central Islip, Newsday reported.
91裸聊视频淭o ruin people91裸聊视频檚 reputations, to do all that, for wealth is really something,91裸聊视频� Seybert said.
James, 54, was convicted in July 2022 of fraud and identity theft charges. Prosecutors say he bilked insurance companies out of hundreds of millions of dollars.
James ran medical billing companies. Prosecutors said he got some doctors to schedule elective surgeries via emergency rooms 91裸聊视频� a tactic that boosted insurance reimbursement rates 91裸聊视频� and billed for procedures that were different from the ones actually performed. When insurance companies rejected the claims, he called, pretending to be an outraged patient or policyholder who was facing a huge bill and demanding that the insurer pay up.
One of the people he impersonated was NBA point guard Marcus Smart, who got hand surgery after hitting a picture frame in 2018, according to court papers filed by James91裸聊视频� lawyers.
Smart was then with the Boston Celtics, where he won the NBA defensive player of the year award in 2022 91裸聊视频� the first guard so honored in more than a quarter-century. Smart now plays for the Memphis Grizzlies.
Smart testified at James91裸聊视频� trial that the impersonation upset him because he wasn91裸聊视频檛 raised to treat people the way James did, and that he was concerned it would damage his standing as a role model, according to prosecutors91裸聊视频� court papers.
Another victim was NFL lawyer and executive Jeff Pash, whose wife was treated for an injury she got while running in 2018. Jurors at James91裸聊视频� trial heard a recording of someone who purported to be Pash 91裸聊视频� but actually was James 91裸聊视频� hollering and swearing at a customer-service representative on an insurance provider91裸聊视频檚 dedicated line for NFL employees, Newsday reported at the time.
91裸聊视频淭hese are people that work for the NFL, and I would hate to have them think that was me on that call,91裸聊视频� Pash testified, saying he knew nothing about it until federal agents told him.
James91裸聊视频� lawyer, Paul Krieger, said in a court filing that James worked as a nurse before starting his own business in 2007. James developed a drinking problem in recent years as he came under stress from his work and family responsibilities, including caring for his parents, the lawyer wrote.
91裸聊视频淗e sincerely and deeply regrets his misguided phone calls and communications with insurance companies in which he pretended to be patients in an effort to maximize and expedite payments for the genuine medical services provided by his doctor-clients,91裸聊视频� the attorney added, saying the calls were 91裸聊视频渁n aberration91裸聊视频� in the life of 91裸聊视频渁 caring and decent person.91裸聊视频�
The Associated Press
