Ten former National Football League (NFL) players have been indicted in the Eastern District of Kentucky, accused of orchestrating a nationwide scheme to defraud a health care benefit program designed for retired NFL players. The charges allege a widespread fraud against the Gene Upshaw NFL Player Health Reimbursement Account Plan, resulting in millions of dollars in false claims.
The Gene Upshaw NFL Player Health Reimbursement Account Plan, established in 2006 as part of a collective bargaining agreement, provides retired NFL players, their spouses, and dependents with tax-free reimbursements for out-of-pocket medical expenses not covered by insurance, up to $350,000 per player. However, according to court documents, a staggering $3.9 million in fraudulent claims were submitted to the Plan, with over $3.4 million being paid out between June 2017 and December 2018.
“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,” stated 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.”
U.S. Attorney Robert M. Duncan Jr. for the Eastern District of Kentucky, added, “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. 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.”
FBI Special Agent in Charge George L. Piro of the Miami Field Office emphasized the broader issue, stating, “This investigation serves as an illustration of the rampant and deliberate scams against health care plans occurring daily throughout the country. 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.” He further noted the extensive reach of the investigation, involving over 20 FBI field offices, highlighting the commitment to combating this type of fraud.
The Indictments: Conspiracy and Fraud Charges
Two separate indictments detail two alleged conspiracies connected to the same scheme to defraud the Plan. The individuals charged include:
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Robert McCune, 40, of Riverdale, Georgia: Facing one count of conspiracy to commit wire fraud and health care fraud, nine counts of wire fraud, and nine counts of health care fraud. McCune is alleged to be a central figure in the scheme.
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John Eubanks, 36, of Cleveland, Mississippi; Tamarick Vanover, 45, of Tallahassee, Florida; and Carlos Rogers, 38, of Alpharetta, Georgia: 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.
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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: Each facing one count of conspiracy to commit wire fraud and health care fraud, one count of wire fraud, and one count of health care fraud.
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Correll Buckhalter, 41, of Colleyville, Texas, and Etric Pruitt, 38, of Theodore, Alabama: Charged with one count of conspiracy to commit wire fraud and health care fraud.
Furthermore, the government has indicated its intention to file criminal informations against Joseph Horn, 47, of Columbia, South Carolina, and Donald “Reche” Caldwell, 40, of Tampa, Florida, for conspiracy to commit health care fraud in the Eastern District of Kentucky.
The Modus Operandi: False Claims for Medical Equipment
The indictments reveal that the fraudulent scheme revolved around submitting false claims to the Plan for expensive medical equipment. These claims, typically ranging from $40,000 to $50,000 each, were for equipment that was never actually purchased or received. The equipment listed on these fraudulent claims included:
- Hyperbaric oxygen chambers
- Cryotherapy machines
- Ultrasound machines (designed for women’s health examinations in doctor’s offices)
- Electromagnetic therapy devices (designed for horses)
According to the indictments, McCune, Eubanks, Vanover, Buckhalter, Rogers, and others allegedly recruited other players into the scheme. They offered to submit or facilitate the submission of these false claims in exchange for kickbacks and bribes, ranging from a few thousand dollars to $10,000 or more per claim. The defendants allegedly fabricated supporting documentation for these claims, including fake invoices, prescriptions, and letters of medical necessity.
To further the scheme, McCune and Buckhalter allegedly impersonated other players in phone calls to the Plan administrators to inquire about the status of the fraudulent claims.
Investigation and Prosecution
The FBI spearheaded the investigation, with significant contributions from over 20 field offices and resident agencies across the country. The prosecution is being handled 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. Trial Attorneys John (Fritz) Scanlon, Alexander J. Kramer, and Thomas J. Tynan from the Criminal Division’s Fraud Section, along with Assistant U.S. Attorneys Paul C. McCaffrey and Andrew E. Smith of the Eastern District of Kentucky, are prosecuting the cases. This case underscores the ongoing efforts to combat health care fraud and hold individuals accountable for exploiting benefit programs.
