Allegations of healthcare fraud are serious. If supported, the government can get substantial financial penalties and additional fines and even, depending on the details of the allegations, push for a prison sentence for those involved in the crime. You may think these types of crimes can only be committed by doctors, nurses, and other healthcare professionals. Afterall, the word “healthcare” is right in the name of the crime.
This assumption would be a mistake — as a group of former National Football League (NFL) players recently demonstrated.
How did NFL players get caught up in allegations of healthcare fraud?
The United States Department of Justice (DOJ) has currently held 15 former NFL players accountable for what the feds claim is a “nationwide scheme to defraud a healthcare benefit program” that was put in place for retired NFL players. The plan provides payments for out-of-pocket expenses not covered by insurance for former players, their spouses, and their dependents.
The feds claim the players submitted false claims for payment for expensive medical equipment. The problem? The players never actually got the equipment. Instead, according to the government, they simply pocketed the payments from the plan.
What are the penalties for this type of a crime?
In this case, the players will likely have to pay restitution, or pay back the funds they received from the plan, as well as additional fines. They also face up to 10 years imprisonment for conspiracy to commit healthcare fraud charges. Additional charges that some players face include wire fraud which comes with up to 20 years imprisonment.
What should others learn from this case?
That healthcare fraud can apply to anyone that bills an insurance provider. As a result, do so carefully and keep records to back up the reason for the claim in the event of an investigation.