Ten former NFL players charged with healthcare fraud

Dolphin Stadium in Miami Gardens, Florida is shown Wednesday, Jan. 24, 2007, as workers prepare for Super Bowl XLI on February 4, 2007. The stadium, home of the Miami Dolphins and the Florida Marlins, will hold up to 75,000 people for the Super Bowl.(Photographer: Richard Sheinwald/ Bloomberg News)
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Ten former National Football League players, including former Washington Redskins running back Clinton Portis, were charged with cheating an NFL healthcare program for retired players out of millions of dollars by faking the purchase of expensive medical equipment like hyperbaric oxygen chambers and ultrasound machines.

They even put in for an electromagnetic therapy device designed for horses, the U.S. Justice Department said.

The 10 players submitted more than $3.9 million in false reimbursement claims in 2017 and 2018, according to a pair of federal indictments unsealed Thursday citing charges of wire fraud, healthcare fraud and conspiracy to commit both. The U.S. named two more players it said it would charge.

The dozen included those who recruited other players eligible for the health plan — submitting or helping them submit fake claims and then taking a cut of the payments — and those for whom the claims were made, the U.S. alleged. Some were both recruiters and claimants. Some impersonated others over the phone to check on the status of their claims.

“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,” Assistant Attorney General Brian Benczkowski said in a statement.

The plan’s tax-favored status was contingent on cash payments to participants being made only for legitimate medical expenses, according to the U.S.

Beyond the dozen players named, one of the indictments included the initials of three players the government says took part in the scheme and who may yet be charged. No current players are believed to have been involved, the U.S. said. It said the investigation continues.

Claims of $40,000 to $50,000 were common, the government said. Forged documents submitted for reimbursement included bills from medical equipment companies as well as letters and prescriptions from healthcare providers.

The total loss to the health plan was $3.4 million, according to Robert Duncan, U.S. attorney for the Eastern District of Kentucky. The alleged fraud stopped when Cigna Healthcare, the plan’s administrator, discovered it and stopped paying. Cigna then alerted federal authorities.

Cigna didn’t respond to a request for comment. An attorney for Portis wasn’t available for comment.

The health care program, the Gene Upshaw NFL Player Health Reimbursement Account Plan, was created after a 2006 collective-bargaining agreement between the NFL’s management and the NFL Players Association to provide benefits to certain retired players, according to the government.

The cases are U.S. v. McCune, 19-cr-206, and U.S. v. Buckhalter, 19-cr-205, U.S. District Court, Eastern District of Kentucky.

This story has been updated with new details.

Bloomberg News
Healthcare fraud Healthcare industry Medical billing