Ten former National Football League players were charged recently for their alleged part in a nationwide scheme to defraud a health care benefit program for retied NFL players according to a Department of Justice release.
The fraud allegedly targeted the Gene Upshaw NFL Player Health Reimbursement Account Plan (the Plan), which was established in 2006, as part of a collective-bargaining agreement. It provides tax-free reimbursement for out-of-pocket medical expenses that are not covered by insurance for health issues incurred by former players and their families.
The Plan has a maximum benefit of $350,000 per player.
Between June 2017 and December 2018, there were allegedly more than $3.9 million in false or and fraudulent claims submitted to the program and the Plan paid out $3.4 million on the claims.
“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 Benczkowski. “Today’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.”
Two separate indictments filed in the Eastern District of Kentucky outline two alleged conspiracies that involving different players related to the same scheme to defraud the Plan. Charged individuals in the indictments include:
- 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.
- 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.
Additionally, the government filed a notice that they intent to file charges against 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.
According to the indictments, the scheme involved submissions of claims to the Plan for expensive medical equipment – usually between $40,000-$50,000 – that was not purchased or received.
The equipment 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.
McCune, Eubanks, Vanover, Buckhalter, Rogers and other players then recruited additional players into the scheme by offering to submit claims in exchange for kickbacks and bribes that ranged from a few thousand dollars to $10,000, or more, per claim submitted.
The defendants allegedly created fake documents that supported the claims including invoices, prescriptions and medical-necessity letters.
After the claims were submitted, McCune and Buckhalter allegedly called the Plan and impersonated other players to check on the status of false and fraudulent claims.
The case was investigated by the Federal Bureau of Investigation and is being prosecuted by the Health Care Fraud Unit of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Kentucky.
The investigation included efforts by various FBI field offices and resident agencies including: Augusta, Georgia; Birmingham and Mobile, Alabama; Cleveland, Ohio; Chicago, Illinois; Columbia, South Carolina; Dallas and Houston, Texas; Denver, Colorado; Jackson, Mississippi; Lexington, Kentucky; New Orleans, Louisiana; Miami, Jacksonville and Tampa, Florida; Newark, New Jersey; Los Angeles, San Diego, Sacramento and Newport Beach, California; Phoenix, Arizona; Salt Lake City, Utah; and Washington, D.C.
Trial attorneys prosecuting the case include John (Fritz) Scanlon, Alexander J. Kramer and Thomas J. Tynan of the Criminal Division’s Fraud Section and Assistant U.S. Attorneys Paul C. McCaffrey and Andrew E. Smith of the Eastern District of Kentucky.
Claire Kowalick, a senior journalist for the Times Record News, covers local government, military and MSU Texas. If you have a news tip, contact Claire at ckowalick@gannett.com.
Twitter: @KowalickNews
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