NFL Players Face Health Care Fraud Charges
ORIGINAL CASE DETAILS
Back in December 2019, ten former National Football League players were charged in federal court in the Eastern District of Kentucky for their roles in an alleged health care fraud scam that spanned the entire country. The alleged health care fraud scam was aimed at the Gene Upshaw NFL Player Health Reimbursement Plan, which was set up for players and provided a form of medical care by reimbursing players for any out-of-pocket medical expenses that are not covered by the player’s health insurance policy. This reimbursement plan allowed for players, their wives and dependents to be paid back up to a maximum of $350,000 a year towards these out-of-pocket expenses. The reimbursement plan was allegedly defrauded out of $3.4 million dollars where players would submit false billings and falsely claim that they bought medical equipment in order to be “reimbursed” by the player plan. As of July 2020, six more players have been charged with similar offenses in a superseding indictment by federal prosecutors. The superseding indictment involves accusations that players falsely claimed they bought medical equipment that cost in upwards of $50,000 in order to be fraudulently reimbursed by the player reimbursement plan. One player in the superseding indictment was even accused of unlawfully using another player’s identity as part of the scheme, leading to aggravated identity theft charges. As of this writing, seven of the players have entered guilty pleas, while others continue to fight their cases.
CRIMINAL CHARGES AND POTENTIAL PENALITES
There are a variety of ways that federal authorities believe that this alleged health care fraud scam was carried out. There are multiple counts charged for each of the listed federal crimes below.
Health Care Fraud: A federal felony that carries up to ten years in federal prison for allegedly defrauding a health care benefit program.
Conspiracy to Commit Health Care Fraud: A federal felony that carries the same maximum as the underlying offense. In this case, this would carry the same 10-year maximum as actual health care fraud.
Wire Fraud: A federal felony that carries up to 20 years in federal prison for allegedly using any means of wire, radio, telephone or other communications device to devise a scheme to defraud.
Conspiracy to Commit Wire Fraud: A federal felony that carries the same maximum as the underlying offense. In this case, this charge would carry the same 20-year maximum as actual wire fraud.
Aggravated Identity Theft: A federal felony that carries an additional two-year sentence in addition to any other term of incarceration. If you have any questions about the federal charges listed above, then it is important that you seek the advice of an experienced federal health care fraud attorney so they can best answer your questions.
If you have any questions about the federal charges listed above, then it is important that you seek the advice of an experienced federal health care fraud attorney so they can best answer your questions.
HOW DOES THIS AFFECT ME?
If you receive a benefit from a federal health care program, this can affect you directly. Even if you are not a formal NFL player accused of defrauding a health care reimbursement fund, you can still find yourself charged with federal health care fraud if you are not truthful in your dealings with a federal health care provider. Anytime a billing or reimbursement from Medicare or Medicaid in perceived to be fraudulent, you can be sure that an investigation and potential criminal charges could soon follow. It is important that you understand that ignorance of the law is not a defense. The fact that you may not have known the law cannot help you in defending against federal criminal charges. If you have been charged with federal health care fraud or are being currently being investigated, then it is imperative that you seek the advice of an experienced federal health care fraud attorney as soon as possible to best understand your current legal options.
