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Ex-Saint Horn pleads guilty to health care fraud

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Published in Breaking News
Friday, 20 December 2019 19:40

Former New Orleans Saints receiver Joe Horn pleaded guilty Thursday to the count of conspiracy to commit health care fraud as part of a plea agreement related to the federal investigation into a group of ex-NFL players accused of defrauding the league's health care benefit program.

Horn was one of 12 players named by Department of Justice officials last week for allegedly submitting nearly $4 million in phony claims, leading to payouts of about $3.4 million between June 2017 and December 2018.

Horn is scheduled to be sentenced in April. Although he is subject to a maximum of 10 years in prison, his cooperation will likely lead to a lesser sentence.

Horn signed documents confirming that he agreed with "former NFL players Tamarick Vanover, Donald (Reche) Caldwell and others to submit false and fraudulent claims to the (Gene Upshaw NFL Player Health Reimbursement Account) Plan, seeking reimbursements for high dollar value durable medical equipment that were never actually provided to vested members."

Ten players were charged last week: Vanover, Clinton Portis, Robert McCune, John Eubanks, Carlos Rogers, Ceandris Brown, James Butler, Fredrick Bennett, Correll Buckhalter and Etric Pruitt. The DOJ also announced that it would seek charges against Horn and Caldwell.

Portis' attorney, Mark Dycio, said in a statement last week that, "Many of the players named in the indictment are shocked to the allegations given that most if not all deny any participation in any scheme to defraud the insurance company. Clinton Portis has no knowledge that his participation in what he believed to be an NFL-sanctioned medical reimbursement was illegal. He is completely taken aback by this indictment and will move forward with the process of clearing his good name and those of his fellow NFL alumni."

Portis told ESPN's John Keim, "I don't have any comment on that."

Prosecutors say the group's alleged ringleaders, McCune and Buckhalter, would recruit former players by offering to submit fake claims to the health care plan. The ringleaders would then demand thousands of dollars in kickbacks for each fake claim, prosecutors allege.

According to the indictments, the players made claims for expensive medical equipment, such as hyperbaric oxygen chambers, cryotherapy machines, ultrasound machines and electromagnetic therapy devices, that wasn't purchased or received. The typical claim was for $40,000 to $50,000.

"Ten former NFL players allegedly committed a brazen, multimillion-dollar fraud on a health care plan meant to help their former teammates and other retired players pay legitimate, out-of-pocket medical expenses," Assistant Attorney General Brian Benczkowski said. "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."

The suspects are accused of fabricating letters from health care providers about using the medical equipment, fabricating prescriptions that were purportedly signed by health care providers and creating fake invoices from medical equipment companies in an effort to prove the equipment was purchased, according to court documents. In reality, they had never purchased or received the medical equipment, prosecutors said.

Investigators believe the defendants forged the prescriptions and authorization letters, and they uncovered no evidence that any doctors were complicit in the scheme, Benczkowski said.

After the phony claims were submitted, the former players would receive reimbursement checks and pay a kickback to the ringleaders and recruiters, the indictments charge.

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