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.
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Led by Insurance Commissioner Ricardo Lara, the California Department of Insurance is the consumer protection agency for the nation's largest insurance marketplace and safeguards all of the state’s consumers by fairly regulating the insurance industry. Under the Commissioner’s direction, the Department uses its authority to protect Californians from insurance rates that are excessive, inadequate, or unfairly discriminatory, oversee insurer solvency to pay claims, set standards for agents and broker licensing, perform market conduct reviews of insurance companies, resolve consumer complaints, and investigate and prosecute insurance fraud. Consumers are urged to call 1-800-927-4357 with any questions or contact us at www.insurance.ca.gov via webform or online chat. Non-media inquiries should be directed to the Consumer Hotline at 800-927-4357. Teletypewriter (TTY), please dial 800-482-4833.