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Ten former NFL players charged with alleged fraud of healthcare benefit program for retired players

Cigna detected and reported the alleged fraud in which the former players allegedly submitted over $3.9 million in false claims.

Susan Morse, Senior Editor

Ten former National Football League players have been charged for allegedly participating in the nationwide fraud of a healthcare benefit program for retired NFL players.

Over $3.9 million in false and fraudulent claims were submitted to the benefits plan, and the plan paid out over $3.4 million on those claims between June 2017 and December 2018, according to the charges.

The alleged fraud targeted the Gene Upshaw NFL Player Health Reimbursement Account Plan, which was established around 2006 to provide tax-free reimbursement of out-of-pocket medical care expenses not covered by insurance that were incurred by former players, their wives and their dependents – up to a maximum of $350,000 per player. 

The alleged 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 medical 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.

The fraud only stopped when Cigna detected it, began refusing to pay claims, and then referred the matter to the Fraud Section of the Department of Justice's Criminal Division for investigation.

The former players have been charged in two separate indictments with conspiracy, wire fraud, and healthcare fraud, for submitting fraudulent claims to the healthcare plan for expensive medical equipment that was never purchased and never received.

The men indicated in the Eastern District of Kentucky are:

Former Baltimore Ravens player Robert McCune, 40, of Riverdale, Georgia. McCune is charged with one count of conspiracy to commit wire fraud and healthcare fraud, nine counts of wire fraud and nine counts of healthcare 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 healthcare fraud, two counts of wire fraud and two counts of health care fraud.

Eubanks was signed by the Washington Redskins; Vanover was with the Kansas City Chiefs; and Rogers was with the Oakland Raiders.

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 healthcare fraud, one count of wire fraud and one count of healthcare fraud.

Portis played for the Denver Broncos; Brown with the Houston Texans; Butler with the New York Giants; and Bennett with the Houston Texans.
Former Philadelphia Eagles player Correll Buckhalter, 41, of Colleyville, Texas, and Seattle Seahawks player Etric Pruitt, 38, of Theodore, Alabama, are charged with one count of conspiracy to commit wire fraud and healthcare fraud.

According to allegations, McCune, Eubanks, Vanover, Buckhalter, Rogers and others recruited other players into the scheme by offering to submit or cause the submission of false and fraudulent claims to the plan in exchange for kickbacks and bribes that ranged from a few thousand dollars to $10,000 or more per claim submitted.  As part of the scheme, the defendants allegedly fabricated supporting documentation for the claims, including invoices, prescriptions and letters of medical necessity.  After the claims were submitted, McCune and Buckhalter allegedly called the telephone number provided by the plan and impersonated certain other players to check on the status of the false and fraudulent claims.

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 healthcare fraud.

This case was investigated by the FBI 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.

ON THE RECORD

"Ten former NFL players allegedly committed a brazen, multi-million dollar fraud on a healthcare 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 healthcare programs to line your own pockets, you will be held accountable by the Department of Justice."

"This investigation serves as an illustration of the rampant and deliberate scams against healthcare 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."

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com