quote:
Portis has pleaded guilty to conspiracy to commit health care fraud. He faces a maximum sentence of 10 years and a fine of not more than $250,000 or twice the gross financial gain from the fraud. He will make restitution of $99,264 to the Gene Upshaw NFL Players Health Reimbursement Account Plan.

As part of the plea deal signed on Friday, Portis admitted that he participated in a scheme to defraud the plan through false or fraudulent pretenses, representations, and promises. Portis basically acknowledges that he made false claims for benefits under the plan.

Specifically, Portis submitted a claim seeking reimbursement in the amount of $44,732 for an oxygen chamber and $54,532 for a cryosauna. He admits that he was “aware of a high probability that these claims sought reimbursement for items that were not medically necessary and . . . deliberately ignored that fact.” He received reimbursement of the full $99,264 that he sought from the plan.

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CanebreakCajun•32 months

So, the insurance company pays it and it is his fault? Do they not review claims before payment?

BlackPot•32 months

"Specifically, Portis submitted a claim seeking reimbursement in the amount of $44,732 for an oxygen chamber and $54,532 for a cryosauna. He admits that he was “aware of a high probability that these claims sought reimbursement for items that were not medically necessary and . . . deliberately ignored that fact.” He received reimbursement of the full $99,264 that he sought from the plan." If I'm reading this right, this ain't his fault. Why did they reimburse him in the first place? Seems like he was just seeing what he could get, and he got what he got. I'm just not understanding how he gets the penalty for insurance throwing money around.

FatDawg•32 months

Filing the claim means you are stating it is medically necessary. If you do that knowing it is not medically necessary, it is fraud. You can not file claims just to see what you can get. There is a lot of small writing that no ones reads in those claims that judges think are important.

NYCAuburn•32 months

They didnt actually get the equipment. it was a scheme along with several others to create fake claims and collect the money to be split. I think it was close to 3 million in total for everyone

LSUTIGER in TEXAS•32 months

Who DOESNT need a cryosauna?!?!?

crewdepoo•32 months

Seems like the heath care company shouldn’t have given him the money. This kind of shite is happening all over southeast Louisiana right now.

TOSOV•32 months

So he tried to get them covered, and they got rejected...whats missing here to make this a court case?

TOSOV•32 months

Ie...I wonder what his false claims were that got him busted.

crewdepoo•32 months

It states it above

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