Saturday, October 9, 2021

NBA Players - Insurance Fraud

More than a dozen former NBA players have been charged in New York federal court in an alleged multi-million-dollar health insurance fraud scheme to rip off the league's benefit plan. 
The 18 former players named in the indictment include alleged scheme ringleader Terrence Williams, selected 11th overall in the 2009 NBA draft by the then-New Jersey Nets, six-time NBA All-Defensive Team member Tony Allen, former Lakers Guard Shannon Brown and Ronald Glen Davis, who played for the Bolton Celtics, Orlando Magic and Los Angeles Clippers over the course of his career. Allen's wife, Desiree Allen, is the only woman charged in the indictment.

Those indicted face charges of conspiracy to commit health care and wire fraud as well as aggravated identity theft. By late morning, 16 of them were in custody after arrests in a dozen locations nationwide.

According to the grand jury indictment, the defendants allegedly engaged in a widespread scheme from at least 2017 up to around 2020 to defraud the NBA Players' Health and Welfare Benefit Plan by submitting fake reimbursement claims for medical and dental services that were never actually rendered. In some cases, the players who submitted the alleged false claims weren't even in the United States at the times they allegedly received the treatments. They allegedly filed fake invoices saying they had to pay for the phantom procedures out of pocket. Those allegedly fraudulent claims totaled about $3.9 million, from which the defendants got about $2.5 million in fraudulent proceeds.

Williams allegedly orchestrated the years-long scheme and recruited other NBA health plan participants to assist by offering them fake invoices to support their claims. He allegedly received at least $230,000 in kickback payments from 10 other players in return for providing the alleged false documentation.

The 34-year-old Williams also allegedly helped three co-defendants -- Davis, Charles Watson Jr. and Antoine Wright -- obtain fake letters of medical necessity to justify some of the services on which the false invoices were based. Williams also allegedly impersonated an individual who processed plan claims at one point in furtherance of his alleged scheme.

Among the false reimbursement claims described in the indictment is a $19,000 claim that Williams filed for chiropractic services he allegedly never had and for which he received $7,672.55 in reimbursement. Williams also allegedly obtained a template for a fake invoice designed to appear as if it had been issued by the office.

Fake chiropractic treatment invoices were allegedly also created for Davis, Watson Jr. and Wright and emailed to Williams. The template had the date, invoice number, services and a charge of $15,000 filled in but left the "bill to" box, where the name of the patient would ordinarily be found, blank.

Williams is accused of emailing those fake invoices to the other defendants named in the indictment. He and defendant Alan Anderson, who briefly played for the Nets from 2013 to 2015, allegedly helped get fake letters of medical necessity for Davis, Watson Jr. and Wright in furtherance of the fraud scheme as well.

Several of the fake invoices and medical necessity forms stood out because, “they are not on letterhead, they contain unusual formatting, they have grammatical errors” and were sent on the same dates from different offices.

In another example, Manhattan U.S. Attorney Audrey Strauss told a news conference, defendant Gregory Smith submitted paperwork for a root canal in Beverly Hills, when he was in fact playing basketball in Taiwan at that time. Others submitted false root canal paperwork as well.

Some of the players were told to repay the money they received from the NBA’s health plan once it was determined that the claims were false. Some did, while others didn’t, according to court documents.

Also named in the indictment: Brooklyn-born Sebastian Telfair, who played for a half-dozen NBA teams including the Cleveland Cavaliers, Clippers, Celtics and Minnesota Timberwolves and Darius Miles, drafted third overall by the Clippers in the 2000 NBA draft and a first-team NBA All-Rookie player.

Prosecutors are seeking "any and all property, real or personal, that constitutes or is derived, directly or indirectly" from the alleged fraud in restitution. If any of that property can't be acquired for whatever reason, the U.S. government says it will seek forfeiture of any other property of the defendants up to the same value.




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