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Man gets 12 years for insurance scheme after posing as patients, including NBA player

Matthew James, 54, ran medical billing companies
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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 weren香蕉视频直播檛 actually due, prosecutors said.. File photo

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 weren香蕉视频直播檛 actually due, prosecutors said.

U.S. District Judge Joanna Seybert called Matthew James香蕉视频直播 actions 香蕉视频直播渋nexcusable香蕉视频直播 as she sentenced him Friday in Central Islip, Newsday reported.

香蕉视频直播淭o ruin people香蕉视频直播檚 reputations, to do all that, for wealth is really something,香蕉视频直播 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 香蕉视频直播 a tactic that boosted insurance reimbursement rates 香蕉视频直播 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 James香蕉视频直播 lawyers.

Smart was then with the Boston Celtics, where he won the NBA defensive player of the year award in 2022 香蕉视频直播 the first guard so honored in more than a quarter-century. Smart now plays for the Memphis Grizzlies.

Smart testified at James香蕉视频直播 trial that the impersonation upset him because he wasn香蕉视频直播檛 raised to treat people the way James did, and that he was concerned it would damage his standing as a role model, according to prosecutors香蕉视频直播 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 James香蕉视频直播 trial heard a recording of someone who purported to be Pash 香蕉视频直播 but actually was James 香蕉视频直播 hollering and swearing at a customer-service representative on an insurance provider香蕉视频直播檚 dedicated line for NFL employees, Newsday reported at the time.

香蕉视频直播淭hese are people that work for the NFL, and I would hate to have them think that was me on that call,香蕉视频直播 Pash testified, saying he knew nothing about it until federal agents told him.

James香蕉视频直播 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.

香蕉视频直播淗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,香蕉视频直播 the attorney added, saying the calls were 香蕉视频直播渁n aberration香蕉视频直播 in the life of 香蕉视频直播渁 caring and decent person.香蕉视频直播

The Associated Press

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