December 16, 2019

How 10 former NFL players allegedly committed $3.9M in health care fraud

Daily Briefing

    The Department of Justice (DOJ) on Thursday announced that it has charged 10 former NFL players with fraud for allegedly submitting false claims for medical equipment totaling $3.9 million to a health benefits program for former players.

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    Details on the charges

    DOJ has charged the former players with making fraudulent claims to the Gene Upshaw NFL Player Health Reimbursement Account Plan. The plan provides tax-free reimbursement for out-of-pocket medical expenses incurred by former NFL players, their spouses, and their dependents.

    The former players allegedly created false documentation—including invoices, prescriptions, and letters of medical need—to make claims for medical equipment, including hyperbaric oxygen chambers, cryotherapy devices, ultrasound equipment used in doctors' offices for imaging on pregnant women, and electromagnetic therapy devices designed for horses, DOJ said. The claims the were typically between $40,000 to $50,000, according to DOJ.

    DOJ said some of the players acted as "ringleaders" in the scheme, recruiting other former players to submit claims for kickbacks and bribes that in some cases reached more than $10,000 per claim. Two of the players even called the health benefits plan impersonating other players to check on the claims, DOJ said.

    In total, DOJ said more than $3.9 million in false claims were filed, and the plan paid out more than $3.4 million between June 2017 and December 2018.

    The fraud was detected by plan administrator Cigna, which became suspicious of the claims and alerted DOJ's medical fraud division.

    The indictments, which were filed in federal court by the Eastern District of Kentucky, are against:

    • Clinton Portis, former Washington Redskins and Denver Broncos running back;
    • Robert McCune, former Redskins linebacker;
    • John Eubanks, former Redskins cornerback;
    • Tamarick Vanover, former Kansas City Chiefs and San Diego Chargers wide receiver;
    • Ceandris "C.C." Brown, former Houston Texans safety;
    • James Butler, former New York Giants and St. Louis Rams safety;
    • Fredrick Bennett, former Texans defensive back;
    • Etric Pruitt, former Atlanta Falcons and Seattle Seahawks defensive back;
    • Carlos Rogers, former Redskins and San Francisco 49ers cornerback; and
    • Correll Buckhalter, former Philadelphia Eagles running back.

    In addition, DOJ intends to charge former New Orleans Saints wide receiver Joe Horn and former San Diego Chargers and New England Patriots wide receiver Donald "Reche" Caldwell with conspiracy, according to the New York Times.

    Reaction

    Assistant Attorney General Brian Benczkowski said, "By defrauding the plan and treating it like their own personal ATM machine, sadly, the defendants placed the plan's tax-exempt status at risk and threatened the ability of law-abiding former players to continue to receive tax-free reimbursements for legitimate medical expenses for themselves or their families."

    George Piro, special agent in charge of the FBI's Miami Field Office, said the charges "serv[e] as an illustration of the rampant and deliberate scams against health care plans occurring daily throughout the country."

    Mark Dycio, an attorney for Portis, said Portis "had no knowledge that his participation in what he believed to be an NFL sanctioned medical reimbursement program was illegal. He is completely taken aback by this indictment and will move forward with the process of clearing his good name and those of his fellow NFL alumni" (Mangan, CNBC, 12/12; Belson, New York Times, 12/12; Fernandez, Axios, 12/12; Levenson et al., CNN, 12/12; DOJ release, 12/12).

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