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Friday, Dec 13 2019

Full Issue

Former NFL Players Charged In $3.4M Scheme Defrauding League Health Care Program

The players allegedly submitted false claims to the Gene Upshaw NFL Player Health Reimbursement Account Plan for reimbursement for medical equipment costing between $40,000 and $50,000. Players who filed the fraudulent claims on behalf of others received “payment of kickbacks and bribes” of up to $10,000 for each false claim.

The federal government charged 10 former National Football League players on Thursday with participating in a scheme that stole $3.4 million from an NFL health care fund for retired players. The U.S. Department of Justice on Thursday announced charges against Robert McCune and nine other ex-players, including Clinton Portis and Correll Buckhalter, for two conspiracies that were linked to the same scheme to defraud the plan. The agency also said it also intends to charge Joe Horn and one other player. (Radnofsky and Gurman, 12/12)

“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,” said assistant Attorney General Brian Benczkowski. (Mangan, 12/12)

The players allegedly submitted false claims to the Gene Upshaw NFL Player Health Reimbursement Account Plan for reimbursement for medical equipment — such as hyperbaric chambers, cryotherapy machines, ultrasound machines used to conduct women’s health exams and electromagnetic therapy devices designed for use on horses — costing between $40,000 and $50,000. According to the indictments, the players fabricated documents, including invoices and prescriptions, to execute the plan. (Kilgore and Maese, 12/12)

In addition, some defendants recruited other retired players to participate in the scheme in exchange for kickbacks and bribes that ranged from a few thousand dollars to $10,000 or more per claim, prosecutors said. McCune and Buckhalter even called the health benefits plan's phone line and impersonated other players to check on the status of the claims, the press release states. Health insurance company Cigna flagged anomalies in the types of claims being filed and referred the fraud to federal investigators, Benczkowski said. (Levenson, Kupperman and Martin, 12/12)

Robert McCune, 36, John Eubanks, 36, Rogers and Brown were all arrested, according to a department official, while six others named in the indictments surrendered voluntarily. The maximum sentence for the charges range from 10 to 20 years, and DOJ noted that all are presumed innocent until proven guilty. (Mallin, 12/12)

Joe Horn, a former standout wide receiver for the New Orleans Saints, is among several former NFL players who have been implicated in an alleged plot to defraud a health care program designed to help retired pro football players and their families. Horn, 47, faces one count of conspiracy to commit health care fraud in a case being pursued by the office of U.S. Attorney Robert Duncan in the Eastern District of Kentucky. His alleged misdeeds are spelled out in a bill of information, which suggests he is cooperating with prosecutors and may already have negotiated a plea deal. (Vargas, 12/12)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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