Benta Jean Fries, CFm, doing business as Silhouette Breast Prosthetics, Fresno, California, faces 67 counts of insurance fraud for allegedly overbilling insurance companies for the “reimbursement of breast prosthetics and undergarments for breast cancer patients” between October 1, 2014, and April 10, 2018.
The Fresno County District Attorney’s Office said in a news release that Fries overbilled insurance companies about $270,415, with potential losses totaling more than $1.2 million.
The alleged fraud was initially detected after breast cancer patients reviewed their explanation of benefits and discovered that their insurance carrier, Blue Shield of California, had been charged by Fries for products they never received, or for more expensive products than they had purchased, the district attorney’s office said. A subsequent Blue Shield investigation was forwarded to the California Department of Insurance.
Fries’ arrest followed a nearly two-year joint investigation. If convicted, Fries faces a sentence of up to 73 years in prison, a fine, and restitution.