United States of America v. Matthew James

Central Islip, New York, criminal defense lawyer represented the Defendant charged with healthcare fraud.



Mathew James, the owner of a medical billing business that submitted insurance claims on behalf of doctors, was tried and convicted on charges of health care fraud, conspiracy to commit health care fraud, wire fraud, and aggravated identify theft. The charges stemmed from James's role in a complex scheme to defraud insurance companies by "upcoding” medical procedures, falsifying reports, directing patients to emergency rooms for pre-planned surgeries, and even impersonating patients in phone calls to the insurance companies. The United States District Court for the Eastern District of New York

(Seybert, J.) sentenced James to 144 months' imprisonment and ordered him to forfeit $63,382,049.02 in criminal proceeds and to pay $336,996,416.85 in restitution.

James was sentenced to 12 years in prison and was ordered to pay restitution in the amount of $336,996,416.85 and forfeiture of $63,382,049.02.



Affirmed