Ten former N.F.L. players, including the former Washington Redskins running back Clinton Portis, were accused of defrauding one of the league’s retiree health care benefit programs out of $3.4 million for phony purchases of medical equipment, federal prosecutors said on Thursday.
Brian A. Benczkowski, assistant attorney general for the criminal division of the United States Department of Justice, said at a news conference that claims totaling $3.9 million were filed and $3.4 million was reimbursed as part of a system that involved kickbacks and the recruiting of players to take part.
According to the indictment, the individual claims, filed from June 2017 to December 2018, averaged $40,000 to $50,000 each for medical equipment that was never prescribed by doctors and never ordered or delivered. Instead, the players are charged with filing fraudulent claims to the plan and, after being reimbursed, sending kickbacks to the ringleaders.
The retired players “treated the plan like it was their own personal A.T.M.,” Benczkowski said.
Benczkowski said that there was no evidence that current players or doctors took part in the scheme and that the yearlong investigation would continue and might expand to include others. Benczkowski said that had the fraud continued, the tax-exempt status of the program for retired players, which was established by the league and the players’ union in 2006, could have been jeopardized, potentially forcing players who received legitimate payments to pay back taxes.
The league and the N.F.L. Players Association administer numerous benefit plans for retired players that cover health care issues ranging from joint replacement to cognitive care to assisted living. But retired players often complain that the league and union make it difficult to file and receive benefits. They also say the operators of the plan use cases involving fraud as an excuse to delay or deny benefits.
The case involving Portis and the other players, though, was triggered by Cigna, the insurance company that administers the Gene Upshaw N.F.L. Player Health Reimbursement Account Plan, which has $800 million in funding and reimburses retired players for out-of-pocket medical care expenses that are not covered by insurance. Players, their spouses and their dependents can receive up to $350,000 per player.
Cigna detected a number of claims for expensive medical equipment, including electromagnetic therapy devices used to treat horses. Cigna then alerted the medical fraud division at the Department of Justice. The league and the players’ union were aware that the grand jury indictments were being filed.
The plan, named after the former union chief Gene Upshaw, is separate from the class-action settlement between the league and retired players that pays as much as $5 million to players with neurological and cognitive diseases, including Alzheimer’s disease, Parkinson’s disease and chronic traumatic encephalopathy. In that case, the league has accused players and doctors of fraud.
According to prosecutors, the scheme was led by three former players, Robert McCune, John Eubanks and Tamarick Vanover. The men recruited other former players to take part by offering to submit fraudulent claims in exchange for kickbacks and bribes. McCune and Eubanks played only briefly in the league, while Vanover spent six years as a kick and punt returner, including five seasons with the Kansas City Chiefs.
The other players gave key information for the claims and knew they were fraudulent when they were filed, the indictments said.
The most prominent player in the group was Portis, who played nine seasons with the Denver Broncos and the Washington Redskins.
The two grand jury indictments, which were filed in the Eastern District of Kentucky, also named Carlos Rogers, a defensive back for the Redskins who last played in 2014; Correll Buckhalter, a running back who spent five seasons with the Philadelphia Eagles; and several other players, including some who played in fewer than 10 N.F.L. games.
McCune was 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. Eubanks, Vanover and Rogers were 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.
Portis, Ceandris Brown, James Butler and Fred Bennett were 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.
Buckhalter and Etric Pruitt were charged with one count of conspiracy to commit wire fraud and health care fraud.
Prosecutors said they intended to file conspiracy charges against two other players, Joseph Horn and Reche Caldwell.
Susan C. Beachy contributed research.
Source: Football - nytimes.com
