Former NFL Player Gets Five Years for Healthcare Fraud

A former player for the National Football League (NFL) has been jailed for five years for his part in a major fraud scheme involving over 50 other players.

Robert McCune, 42, of Riverdale, Georgia, had already pleaded guilty to one count of conspiracy to commit health care fraud and wire fraud, 10 counts of wire fraud, 12 counts of healthcare fraud and three counts of aggravated identity theft.

He’s said to have defrauded the Gene Upshaw NFL Player Health Reimbursement Account Plan, which offers all players $350,000 in tax-free, out-of-pocket medical care expenses for anything not covered by insurance.

Between June 5 2017 and April 12 2018, McCune submitted false documents on behalf of dozens of former players and himself, seeking reimbursement for non-existent medical treatment and equipment, according to the Department of Justice (DoJ).

This included expensive items such as hyperbaric oxygen chambers, ultrasound machines and electromagnetic therapy devices.

McCune and his co-conspirators are said to have submitted around $2.9m in fraudulent claims in this way.

He’s also said to have demanded bribes and kickbacks in the thousands of dollars for claims submitted on behalf of others, using their name, insurance identification number, social security number, mailing address and date of birth.

Thirteen other defendants have already been sentenced for their role in the scheme, although a total of 68 claims were submitted on behalf of 51 players, the DoJ said.

If anything, healthcare fraud is an even bigger problem today than at the time of McCune’s wrongdoing, thanks to the COVID crisis.

The US authorities opened a record number of cases in 2020: out of 900 new investigations that year, 580 were related to healthcare fraud, according to the DoJ.

The growth of telemedicine during the pandemic has been a major driver of cybercrime, as it’s easier to fake consultations and prescriptions when patients don’t need to be physically present in clinics.