Typically, doctors and other medical providers are at the center of large-scale health care fraud cases. However, 18 former players for the National Basketball Association (NBA) are facing federal charges for conspiracy to defraud their league’s Health and Welfare Benefit Plan.
Prosecutors allege that the former players submitted fraudulent medical and dental claims totaling close to $4 million to the plan for services they never received and payments they hadn’t made. Before they were caught, prosecutors claim that the men received about $2.5 million of that amount.
Alleged ringleader accused of taking kickbacks
A former shooting guard for the Houston Rockets, Terrence Williams, allegedly was the ringleader of the group. In addition to health care and wire fraud charges, he’s also been charged with aggravated identity theft.
He’s accused of taking kickbacks totaling about $230,000 from the other players in return for giving them phony invoices to provide with their claims. However, he also allegedly impersonated health plan administrators to question one player’s fraudulent claims after he refused to give him his kickback.
How the investigation unfolded
It appears that some of the players were working with authorities to help make a case against others in exchange for avoiding charges. There are references in the indictment to at least two unnamed co-conspirators.
The alleged conspiracy was reportedly spotted by the health care board. Because the claims and invoices were submitted via email, the Federal Bureau of Investigation (FBI) could easily access them. In one case, they were able to determine through customs records that one of the players was abroad when he was supposedly getting thousands of dollars worth of dental work in Beverly Hills.
While this alleged fraud was on a large scale, it’s important to understand that activity like this, even on a smaller scale, violates federal law. Health care fraud charges can easily be accompanied by mail and/or wire fraud charges, depending on how the alleged fraud was carried out. If you believe you’re being investigated or are already facing charges, it’s crucial that you get legal guidance before you speak to any authorities.