NFL Stars Accused of Fraud on Health Care Program for Retired Football Players
A number of former National Football League (NFL) stars were charged in the Eastern District of Kentucky on Thursday for their suspected participation in a nationwide health care scam within the NFL benefit program for retired players.
The 10 players suspected of the fraud allegedly targeted the “Gene Upshaw NFL Player Health Reimbursement Account Plan,” which had been established as a result of the collective bargaining agreement of 2006. The deal provided tax-free reimbursement of out-of-pocket medical care expenses that were not covered by insurance and that were incurred by former players, their wives and their dependents.
The coverage of the health care is in addition to other health insurance, such as Medicare or a private insurance provider, giving the players and their families up to a maximum of $350,000 per player on top of other healthcare plans.
According to the charging documents, over $3.9 million in false and fraudulent claims were submitted to the Plan, and the Plan paid out over $3.4 million on those claims between June 2017 and December 2018.
According to allegations in the indictments (See list of names below this news story), McCune, Eubanks, Vanover, Buckhalter, Rogers and others allegedly recruited other players to submit false and fraudulent claims while they collected kickbacks and bribes for as much as $10,000 or more per claim submitted.
As part of their alleged scam, the scammers allegedly provided documentation for the phony claims, including invoices, prescriptions and letters of medical necessity.
“Ten former NFL players allegedly committed a brazen, multi-million-dollar fraud on a health care plan meant to help their former teammates and other retired players pay legitimate, out-of-pocket medical expenses,” said Assistant Attorney General Brian Benczkowski.
“Today’s [Thursday’s] indictments underscore that whoever you are, if you loot health care programs to line your own pockets, you will be held accountable by the Department of Justice.”
“The defendants are alleged to have developed and executed a fraudulent scheme to undermine a health care benefit plan established by the NFL – one established to help their former teammates and colleagues pay for legitimate medical expenses,” said U.S. Attorney Robert M. Duncan Jr., for the Eastern District of Kentucky.
“The defendants allegedly submitted false claims to the plan and obtained money for expensive medical equipment that was never purchased or received, depriving that plan of valuable resources to help others meet their medical needs. We have prioritized the investigation and prosecution of health care fraud in our office, and we appreciate the partnership we share with the Criminal Division and the FBI in pursuing these important matters,” Duncan said in a press release.
“This investigation serves as an illustration of the rampant and deliberate scams against health care plans occurring daily throughout the country,” said FBI Special Agent in Charge George L. Piro of the Miami Field Office. “In this case, these fraudsters pocketed money from the Gene Upshaw National Football League Health Reimbursement Account Plan that was intended for former NFL players who are ill or infirm. Over 20 FBI field offices participated in this investigation which demonstrates the level of commitment we have to rooting out this type of fraud,” Piro stated.
Two separate indictments filed in the Eastern District of Kentucky outline two alleged conspiracies involving different players related to the same scheme to defraud the NFL Healthcare Plan. Those charged in the indictments are the following:
- Robert McCune, 40, of Riverdale, Georgia, is charged with one count of conspiracy to commit wire fraud and health care fraud, nine counts of wire fraud and nine counts of health care fraud. McCune played Linebacker for the Baltimore Ravens until 2008.
- John Eubanks, 36, of Cleveland, Mississippi; Tamarick Vanover, 45, of Tallahassee, Florida; and Carlos Rogers, 38, of Alpharetta, Georgia, are each charged with one count of conspiracy to commit wire fraud and health care fraud, two counts of wire fraud and two counts of health care fraud.
- Clinton Portis, 38, of McLean, Virginia; Ceandris Brown, 36, of Fresno, Texas; James Butler, 37, of Atlanta, Georgia; and Fredrick Bennett, 35, of Port Wentworth, Georgia, are each charged with one count of conspiracy to commit wire fraud and health care fraud, one count of wire fraud and one count of health care fraud.
- Correll Buckhalter, 41, of Colleyville, Texas, and Etric Pruitt, 38, of Theodore, Alabama, are charged with one count of conspiracy to commit wire fraud and health care fraud.
In addition, the government has filed notice that it intends to file criminal informations charging Joseph Horn, 47, of Columbia, South Carolina, and Donald “Reche” Caldwell, 40, of Tampa, Florida, with conspiracy to commit health care fraud in the Eastern District of Kentucky.
The indictments charge that the scheme to defraud involved the submission of false and fraudulent claims to the Plan for expensive medical equipment – typically between $40,000 and $50,000 for each claim – that was never purchased or received. The expensive medical equipment described on the false and fraudulent claims included hyperbaric oxygen chambers, cryotherapy machines, ultrasound machines designed for use by a doctor’s office to conduct women’s health examinations and electromagnetic therapy devices designed for use on horses.
