Current:Home > NewsMan gets 12 years in prison in insurance scheme after posing as patients, including NBA player-InfoLens
Man gets 12 years in prison in insurance scheme after posing as patients, including NBA player
View Date:2024-12-23 12:24:34
CENTRAL ISLIP, N.Y. (AP) — 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’t actually due, prosecutors said.
U.S. District Judge Joanna Seybert called Matthew James’ actions “inexcusable” as she sentenced him Friday in Central Islip, Newsday reported.
“To ruin people’s reputations, to do all that, for wealth is really something,” 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 — a tactic that boosted insurance reimbursement rates — 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’ lawyers.
Smart was then with the Boston Celtics, where he won the NBA defensive player of the year award in 2022 — the first guard so honored in more than a quarter-century. Smart now plays for the Memphis Grizzlies.
Smart testified at James’ trial that the impersonation upset him because he wasn’t 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’ 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’ trial heard a recording of someone who purported to be Pash — but actually was James — hollering and swearing at a customer-service representative on an insurance provider’s dedicated line for NFL employees, Newsday reported at the time.
“These are people that work for the NFL, and I would hate to have them think that was me on that call,” Pash testified, saying he knew nothing about it until federal agents told him.
James’ 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.
“He 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,” the attorney added, saying the calls were “an aberration” in the life of “a caring and decent person.”
veryGood! (53)
Related
- Man gets a life sentence in the shotgun death of a New Mexico police officer
- A murder warrant is issued for a Massachusetts man wanted in the shooting death of his wife
- Singer Michael Bublé unveils new whiskey brand Fraser & Thompson
- China sends its youngest-ever crew to space as it seeks to put astronauts on moon before 2030
- Deebo Samuel explains 'out of character' sideline altercation with 49ers long snapper, kicker
- Victoria's Secret releases collection of adaptive garments for people with disabilities
- A list of mass killings in the United States since January
- Russian drone debris downed power lines near a Ukraine nuclear plant. A new winter barrage is likely
- What Republicans are saying about Matt Gaetz’s nomination for attorney general
- Book excerpt: Mary and the Birth of Frankenstein by Anne Eekhout
Ranking
- Amtrak service disrupted after fire near tracks in New York City
- Taliban free Afghan activist arrested 7 months ago after campaigning for girls’ education
- Matthew McConaughey and wife Camila introduce new Pantalones organic tequila brand
- New organic rules announced by USDA tighten restrictions on livestock and poultry producers
- Brian Austin Green’s Fiancée Sharna Burgess Celebrates Megan Fox’s Pregnancy News
- Millie Bobby Brown Embraces Her Acne Breakouts With Makeup-Free Selfie
- NFL Week 8 odds: Moneylines, point spreads, over/under
- Paris museum says it will fix skin tone of Dwayne The Rock Johnson's wax figure
Recommendation
-
Louisville officials mourn victims of 'unthinkable' plant explosion amid investigation
-
Strong US economic growth for last quarter likely reflected consumers’ resistance to Fed rate hikes
-
Emerging filmmakers honored with Student Academy Awards at 50th anniversary ceremony
-
Bad sign for sizzling US economy? How recent Treasury yields could spell trouble
-
J.Crew Outlet Quietly Drops Their Black Friday Deals - Save Up to 70% off Everything, Styles Start at $12
-
Turbocharged Otis caught forecasters and Mexico off-guard. Scientists aren’t sure why
-
The Masked Singer Reveals a Teen Heartthrob Behind the Hawk Costume
-
I had two very different abortions. There's no one-size policy for reproductive health.