St. James man convicted of $600M healthcare fraud

A St. James man was convicted Wednesday in federal court in Central Islip in a $600 million healthcare fraud scheme.

Following a six-week trial, a jury found Mathew James guilty on eight counts of charges in a scheme that impersonating patients on calls – including from an NFL executive and an NBA player – to insurance companies and staging fake ER visits to fraudulently inflate claims, federal officials said.

“The defendant stands convicted of carrying out an audacious scheme in which he used insurance companies like ATM machines,” U.S. Attorney Breon Peace said in a written statement about the conviction.

“He stole hundreds of millions of dollars until he was finally exposed by a paper trail a mile-long, phone recordings on which he impersonated patients, and text messages and emails with his co-conspirator doctor clients demonstrating his nefarious billing practices,” Peace added. “Health care fraud is not a victimless crime, because fraudulent billing ultimately affects consumers who must pay the cost of higher insurance premiums.”

“James orchestrated a fraudulent medical billing scheme to steal from insurance companies and businesses, in order to line his own pockets,” Assistant Attorney General Kenneth Polite of the Justice Department’s Criminal Division said in a statement. “This conviction shows that medical billers who fuel health care fraud will be brought to justice.”

Source: St. James man convicted of $600M healthcare fraud / Long Island Business News

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