May 2, 2021

Memo: Dozens of former NFL player involved in insurance fraud

Dozens of former professional football players filed fake insurance claims in recent years but were…

Dozens of former professional football players filed fake insurance claims in recent years but were not charged in the scheme, according to a sentencing memorandum in a federal court case.

The investigation has resulted in charges against 15 former National Football League players in federal court in Lexington.

However, the insurance company involved in the case, Cigna, identified a total of 77 former NFL players who submitted fraudulent claims for medical equipment beginning in 2017, according to the court document.

The document did not disclose the names of anyone not charged in the case.

The information was filed in a sentencing memorandum in the case against Carlos Rogers, who played at Auburn University before spending a total of 10 years in the NFL as a cornerback at Washington, Oakland and San Francisco.

Lexington attorney Thomas C. Lyons represents Rogers and prepared the memo using information turned over by federal authorities to defense attorneys.

In this Jan. 15, 2014 file photo, San Francisco 49ers cornerback Carlos Rogers adjusts his helmet during practice at an NFL football training facility in Santa Clara, Calif. Ten former NFL players have been charged with defrauding the league’s healthcare benefit program. They include five who played on the Washington Redskins, including Clinton Portis and Carlos Rogers. (AP Photo/Jeff Chiu) Jeff Chiu AP

U.S. District Judge Karen K. Caldwell sentenced Rogers on Thursday to time served — which was one day — and six months on home incarceration, according to his attorney. Caldwell also fined Rogers $10,000.

Lyons said Caldwell’s decision was “well reasoned and eminently fair.”

The sentencing range for Rogers under advisory guidelines was 12 to 18 months behind bars, but Lyons had argued for a lesser sentence.

Prosecutors brought charges against Rogers and 14 other players for allegedly defrauding the Gene Upshaw NFL Player Health Reimbursement Account Plan.

That plan provides up to $350,000 apiece to reimburse former players for medical expenses not covered by insurance.

NFL teams pay into the plan.

Indictments charged that former players requested reimbursement for expensive medical equipment that they didn’t actually buy or receive, including hyperbaric oxygen machines and electromagnetic therapy devices designed for use on horses.

The former players in the case don’t live in Kentucky. The case is being handled in the state because Cigna processed claims to the NFL plan through a data center in Lexington.

That allowed federal authorities to consolidate the cases in Kentucky instead of filing charges in several places.

The U.S. Department of Justice said more than 20 FBI offices took part in the investigation.

Lyons said in the sentencing memo that it appears a former player, identified only as J.D., may have filed the first fraudulent claim in June 2017.

Those initials don’t match any of the players publicly charged so far.

Word spread that there was a way for former NFL players to get money from the health account, Lyons said.

For instance, one former player told investigators that John Eubanks posted a message on Facebook about looking for ex-players who wanted to draw money from the health plan, according to the memo.

Eubanks was charged in the case and has pleaded guilty.

There also was a group text involving 40 to 50 players discussing ways to get money from the health plan, the memo said.

By 2018, two schemes had developed to submit fraudulent claims, led by two different former players, Rogers’ memo said.

The people leading the scheme received kickbacks from other former players to file false claims for them, supported with fake invoices and other documents, prosecutors said.

Lyons said in his client’s memo that at least 60 former players received big reimbursments, often $40,000 or more in a single claim, for equipment they didn’t really buy or expect to receive.

However, only a few were charged.

Most were allowed to repay the money, even though they knew they received it under false pretenses, Lyons wrote.

Some players who paid Correll Buckhalter to file fake claims for them didn’t even have to pay back the money, the memo said.

Rather, they just had to pay taxes on the checks they got, “for equipment they never received, authorized by doctors they had never seen,” Lyons wrote.

The U.S. Department of Justice declined comment Thursday on why some players were charged in the case and others were not.

Buckhalter, who played for the Denver Broncos and Philadelphia Eagles, has pleaded guilty but has not been sentenced.

Lyons said numerous former players told investigators they believed the money set aside in health accounts in their names belonged to them.

Rogers was among those who believed that players owned the money in their accounts, Lyons said. Rogers later came to understand the money in the account wasn’t his, Lyons said.

In seeking a sentence for Rogers before the guideline range, Lyons argued that Rogers had only a minimal role in the scheme and that his involvement didn’t ultimately cause any loss to the health plan.

In early 2018, Rogers heard several friends discuss how former NFL players were getting money out of the health account.

Buckhalter told Rogers he knew a doctor who could help in getting access to the money, and that Buckhalter would pay Rogers a small fee for referring former players to him, the memo said.

Rogers ultimately gave Buckhalter information on four former players, and Buckhalter paid him $6,500. That was the only money Rogers received, according to the memo.

The four claims that resulted were for a total of approximately $179,814, but the plan paid only one, for $56,821, and the former player who got it, identified only as M.K., later repaid the money, according to Rogers’ memo.

Rogers didn’t falsify any documents or submit any paperwork to Cigna, and didn’t know others were forging prescriptions as part of the scheme, Lyons said.

In comparison, Buckhalter and J.D. falsified paperwork on dozens of claims, forged doctors’ signatures, impersonated other former players in calls to Cigna to check on claims, and “lied to everyone, including Rogers, about the full extent of this fraud,” Lyons wrote.

Lyons also said Rogers deserved a lower sentence because of his character. People describe him as a humble man of faith and principle who is “extraordinarily attached” to his daughter, Lyons said.

“Rogers could have never imagined committing a federal felony, but he was drawn into the Buckhalter scheme in a significant lapse of judgment, for which he will always be ashamed and remorseful,” Lyons wrote.

Prosecutors said in a sentencing memo that Rogers did have significant involvement in the fraud.

He brought others into the scheme, knew the amount of the kickback required to get a claim filed and checked on the status of bogus claims, prosecutors said.

Text messages show Rogers knew it would take fraud to get the health plan to pay, and told Buckhalter to give his cut of the kickbacks to his wife, suggesting he wanted to conceal them, prosecutors said.

“Rogers committed an intentional and significant fraud on a health care plan that was established specifically to help his fellow retired NFL players and their families pay for out-of-pocket health care costs,” prosecutors said. “Health care fraud like that committed by Rogers contributes greatly to the inflated cost of health care in this country.”

Of the 15 former NFL players charged in the investigation, 12 have pleaded guilty but Rogers is only the second to be sentenced.

Ceandris Brown was sentenced to a year and a day in prison and restitution of $84,777.

In addition to Rogers, Buckhalter, Eubanks and Brown, the others who pleaded guilty were James Butler, Fredrick Bennett, Etric Pruitt, Antwan Odom, Anthony Montgomery, Darrell Reid, Joe Horn and Donald “Reche” Caldwell.

Caldwell, who played for the San Diego Chargers and New England Patriots, was shot and killed in an apparent robbery attempt before he was sentenced.

U.S. District Judge Karen K. Caldwell has scheduled several of the former players to be sentenced in October.

Former players Clinton Portis, Tamarick Vanover and Robert McCune are scheduled for trial in August.