Central Valley business owner arrested for billing scheme targeting billing scheme targeting breast cancer patients
News: 2018 Press Release
FRESNO, Calif. — Benta Jean Fries, 49, of Clovis was arrested today on 67 felony counts for allegedly running a health care fraud scam that netted more than $270,000, with potential losses of more than $1.2 million.
“Health insurance fraud is a multi-billion dollar drain on the economy,” said Insurance Commissioner Dave Jones. “This type of fraud is particularly egregious because it often involves professionals who are looking to make a quick profit by taking advantage of patients who are fighting for their lives.”
A joint investigation by the California Department of Insurance and the Fresno County District Attorney’s Office revealed that between October 2014 and April 2018 Benta Fries, doing business as Silhouette Breast Prosthetics submitted fraudulent charges to six different health insurance companies. Silhouette Breast Prosthetics provides breast prosthetics and undergarments for breast cancer patients and contracts with health insurance companies to reimburse for those items deemed medically necessary.
According to detectives, Fries would bill insurance companies for products patients never received or for more expensive products than patients purchased. The fraud was discovered when a patient reviewed her explanation of benefits and found charges for products she did not receive. Fries has been booked into Fresno County Jail with bail set at $1.025 million. This case is being prosecuted by the Fresno County District Attorney’s Office.
# # #
The California Department of Insurance, established in 1868, is the largest consumer protection agency in California. Insurers collect $310 billion in premiums annually in California. Since 2011 the California Department of Insurance received more than 1,000,000 calls from consumers and helped recover over $469 million in claims and premiums. Please visit the Department of Insurance website at www.insurance.ca.gov. Non-media inquiries should be directed to the Consumer Hotline at 800-927-4357. Teletypewriter (TTY), please dial 800-482-4833.