A Saint James person was convicted of scamming health insurance companies out of extra than $600 million by fraudulently padding health-related charges, conspiring with doctors, and impersonating sufferers.
A jury observed Mathew James responsible Wednesday of wire fraud and aggravated identity theft rates but acquitted him of income laundering charges next a 6-7 days-extensive demo at Central Islip federal court docket.
“He used insurance coverage providers like ATM devices,” reported Breon Peace, U.S. Lawyer for the Eastern District of New York. “He was last but not least uncovered by a paper trail a mile-long, cell phone recordings on which he impersonated sufferers, and textual content messages and emails with his co-conspirator medical doctor clients demonstrating his nefarious billing techniques.”
Prosecutors mentioned the 54-year-aged gentleman utilized his clinical billing corporations that mainly served plastic surgeons nationwide to defraud insurance policy organizations by publishing statements to insurance policy providers for strategies that were being either additional critical or solely different than these his physician-purchasers carried out.
He also produced 1000’s of phone calls impersonating individuals, like Jeff Pash, the Nationwide Soccer League’s typical counsel, and Marcus Clever, a skilled basketball participant for the Boston Celtics, authorities said.
In addition, he directed his physician-purchasers to program elective surgical procedures by way of the emergency space so that coverage firms would reimburse at considerably bigger costs, according to investigators.
He will be sentenced by U.S. District Choose Joanna Seybert at a afterwards date.
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