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Three former NFL players plead guilty in multimillion-dollar health care fraud scheme

1 year 3 months 1 day ago Wednesday, September 08 2021 Sep 8, 2021 September 08, 2021 7:22 AM September 08, 2021 in News
Source: CNN

Clinton Portis is one of three former NFL players who have pleaded guilty for their participation in a nationwide scheme to defraud a health care program for retired NFL players

According to CNN, two-time Pro Bowl running back Portis joined Tamarick Vanover and Robert McCune in admitting to submitting false claims for payouts totaling about $3 million. 

The Justice Department explained Tuesday that the targeted Healthcare program, 'The Gene Upshaw NFL Player Health Reimbursement Account Plan,' was designed to provide tax-free reimbursement to former players and their families for out-of-pocket medical expenses not covered by insurance.

But former NFL players took advantage of the program by submitting phony claims for expensive equipment such as hyperbaric oxygen chambers, ultrasound machines designed for a doctor's office to conduct women's health exams, and electromagnetic therapy devices for horses.

The claims were for about $40,000 to $50,000 each and involved the creation of fabricated invoices, prescriptions and letters of medical necessity.

Prosecutors also said some of the former NFL athletes recruited fellow football stars who'd since retired from the NFL, persuading them to participate in the scheme in exchange for kickbacks and bribes.

Officials pinpointed McCune as the brains behind the scheme.

According to the Justice Department, "McCune orchestrated the nationwide fraud, which resulted in approximately $2.9 million in false and fraudulent claims being submitted to the Plan and the Plan paying out approximately $2.5 million on those claims between June 2017 and April 2018."

McCune was a standout athlete who participated in eight NFL games over a period of four seasons.

The 40-year-old former linebacker now faces extensive jail time and is scheduled to face a judge for sentencing on November 19.

According to CNN, at maximum, McCune can be sentenced to 20 years in prison for conspiracy to commit wire fraud and health care fraud, in addition to 10 years for each count of health care fraud, 20 years for each count of wire fraud and two years for each count of aggravated identity theft. 

His fellow former NFL colleagues, Portis and Vanover, will face sentencing on January 6 and January 22, respectively. 

Both players face a maximum penalty of 10 years in prison.

McCune's plan to defraud the system reportedly went into effect in June of 2017 and ended over a year later, in December of 2018. Prosecutors said it led to over $3.9 million in false and fraudulent claims, of which the plan paid out more than $3.4 million.

Suspicions rose when health insurance company Cigna flagged anomalies in the types of claims that were being filed and referred the fraud to federal investigators.

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