Saint James Man Convicted of $600M Health Insurance Fraud

A Saint James guy was convicted of scamming wellness coverage providers out of additional than $600 million by fraudulently padding professional medical expenditures, conspiring with physicians, and impersonating sufferers.

A jury discovered Mathew James responsible Wednesday of wire fraud and aggravated id theft prices but acquitted him of money laundering costs pursuing a six-week-extended demo at Central Islip federal courtroom.

“He used  insurance coverage firms like ATM devices,” explained Breon Peace, U.S. Attorney for the Japanese District of New York. “He was finally uncovered by a paper path a mile-lengthy, mobile phone recordings on which he  impersonated sufferers, and text messages and email messages with his co-conspirator health practitioner clients  demonstrating his nefarious billing methods.”

Prosecutors said the 54-year-aged male made use of his health care billing companies that largely served plastic surgeons nationwide to defraud insurance policies corporations by distributing statements to insurance plan corporations for methods that had been both additional significant or solely different than all those his physician-consumers performed. 

He also made hundreds of phone calls impersonating people, together with Jeff Pash, the National Soccer League’s general counsel, and Marcus  Good, a experienced basketball participant for the Boston Celtics, authorities stated. 

In addition, he directed his health care provider-clients to program elective surgical procedures by way of the emergency room so that insurance policies firms would reimburse at substantially greater prices, according to investigators. 

He will be sentenced by U.S. District Choose Joanna Seybert at a later date.