A former professional football player was convicted this week of orchestrating a sprawling health care fraud scheme that federal prosecutors say siphoned $197 million from Medicare and a federal health program serving veterans’ families.
Prosecutors said French used a network of marketing companies, telemedicine providers, and durable medical equipment suppliers to obtain patient information and signed medical orders that were later sold to billing entities. Many of the patients targeted were elderly or cognitively impaired, including individuals suffering from Alzheimer’s disease or dementia.
Rather than beginning with medical evaluations, the scheme relied on overseas call centers that contacted Medicare beneficiaries and pressured them to accept orthopedic braces they did not request or need, according to court records. In some cases, recordings of those calls were altered to falsely indicate patient consent.
French then paid telemedicine companies to obtain signed orders from doctors and nurse practitioners who had not examined, or in some cases even spoken with, the patients, according to evidence presented at trial. Those orders were later used to bill Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs, known as CHAMPVA.
The government said French concealed his ownership and control of at least eight medical supply companies by using false documentation, allowing the businesses to submit claims while appearing independent. Claims were submitted for braces billed to deceased beneficiaries and amputees for limbs they no longer had, prosecutors said.
Financial records introduced at trial showed French withdrew large sums of cash during the conspiracy, including tens of thousands of dollars used to pay individuals who supplied beneficiary data.
In a statement following the verdict, Assistant Attorney General A. Tysen Duva said the case underscored federal efforts to protect taxpayer-funded health care programs from abuse. “These schemes undermine the integrity of our health care system by robbing taxpayer-funded programs meant for legitimate medical care,” he said.
French was convicted of conspiracy to commit health care fraud and wire fraud, conspiracy to commit money laundering, and conspiracy related to illegal kickbacks. He faces up to 20 years in prison on the most serious count. A sentencing date has not yet been scheduled.
The investigation involved the FBI, HHS-OIG, and VA-OIG. Federal prosecutors said the case was part of broader enforcement efforts targeting large-scale health care fraud nationwide.
“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,” Duva said.