Former NFL Player Convicted for $197M Medicare Fraud

FLORIDA—A federal jury in the Middle District of Florida convicted the owner of a marketing company, and former NFL player, for his role in a years-long scheme to bilk Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) out of nearly $200 million by allegedly selling patient information and sham doctors’ orders for orthotic braces that patients did not want or need.

According to court documents and evidence presented at trial, Joel Rufus French, 47, of Amory, Mississippi, worked with overseas call centers that pressured elderly Americans to provide their personal and health insurance information and agree to accept medically unnecessary orthotic braces. Some of the individuals who agreed to the braces suffered from Alzheimer’s and dementia. In certain instances, the call centers altered call recordings to make it seem like Medicare patients agreed to the braces when they did not.

“This defendant’s conduct was egregious: he targeted seniors suffering from Alzheimer’s and dementia and billed Medicare for orthotic braces for deceased patients and amputees,” said Assistant Attorney General A. Tysen Duva of the Justice Department’s criminal division. “These schemes undermine the integrity of our health care system by robbing taxpayer-funded programs meant for legitimate medical care. Today’s verdict sends a clear message: the criminal division will aggressively prosecute those who prey on our nation’s seniors and veterans to steal from Medicare.”

French allegedly paid sham telemedicine companies to obtain signed orders from doctors and nurse practitioners who never examined, and often never even spoke to, the patients. He sold the orders to marketers and medical supply companies, which then submitted claims to Medicare. Documents say French also defrauded Medicare and CHAMPVA, the health care program for spouses and children of veterans who have or had a permanent and total service-connected disability or who died from a service-connected condition, by billing the programs for orthotic braces through eight durable medical equipment supply companies that he owned and managed, using false documents to hide his connection to the companies from Medicare. 

The evidence at trial showed that French and his co-conspirators caused Medicare to be billed for braces for amputees for limbs they did not have and for deceased beneficiaries. Also during the conspiracy, French withdrew approximately $225,000 in cash from a bank in Mississippi, over $10,000 of which was placed in a bag and driven to Orlando to pay accomplices who sold him beneficiaries’ personal and insurance information.

The jury convicted French of conspiracy to commit health care fraud and wire fraud, conspiracy to commit money laundering and conspiracy to offer, pay, solicit and receive kickbacks. French faces a maximum penalty of 20 years in prison for conspiracy to commit health care fraud and wire fraud, 10 years in prison for conspiracy to commit money laundering and five years in prison for conspiracy to defraud the United States. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors. A sentencing date has not been set.