Man Sentenced to 12 Years in Jail for Posing as Marcus Smart, Others in Fraud Scheme

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A Long Island medical biller has been sentenced to 12 years in federal prison for impersonating numerous patients, including Memphis Grizzlies guard Marcus Smart, in an insurance fraud scheme, according to the Associated Press (h/t ESPN).

Matthew James, 54, was convicted of fraud and identity theft in July 2022 after swindling insurance companies out of hundreds of millions of dollars.

James used his medical billing companies to get doctors to schedule elective surgeries through emergency rooms, which inflated insurance reimbursement rates, and also billed for procedures that were different than the ones 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,” the Associated Press wrote.

James impersonated Smart in 2018 when the former Boston Celtics star underwent hand surgery, according to court papers filed by his lawyers. Smart testified at James’ trial that he was concerned that the impersonation scheme would damage his reputation as a role model, per prosecutors’ court papers.

James also impersonated NFL lawyer and executive Jeff Pash, whose wife was treated for a running injury in 2018. He called the insurance provider’s dedicated line for NFL employees pretending to be Pash and began “hollering and swearing” at the customer-service representative.

“These are people that work for the NFL, and I would hate to have them think that was me on that call,” Pash testified.

James’ lawyer said he started his own business in 2007 following a career as a nurse. His lawyer added that he had “developed a drinking problem in recent years as he came under stress from his work and family responsibilities, including caring for his parents.”

“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,” his attorney said.