Amtrak Health Care Fraud Scheme Involves 119 Employees

Amtrak health care fraud uncovered a $12 million scheme involving 119 employees and corrupt medical professionals, yet over half of those implicated are still employed at the national rail company. This is reported by the railway transport news portal Railway Supply.

An internal investigation revealed that staffers accepted bribes from doctors who submitted fake claims to Amtrak’s health insurance plan. Some employees went further, extorting providers to increase their share of profits.

Don’t miss…Amtrak Bribery Scandal Exposes Multi-Million Dollar Corruption

Inspector General Kevin H. Winters criticized what he called a “troubling workforce culture” in the Northeast region, where criminal conduct appeared normalized and ethical standards were severely lacking.

Several workers even provided their children’s insurance information to help file fraudulent claims. The fraud spanned from 2019 to 2022 and remained undetected until billing patterns raised suspicion.

Amtrak Health Care Fraud Prompts Criminal Charges and Resignations

A dozen employees now face criminal charges. Seven have pleaded guilty and await sentencing, while 28 resigned or retired during the investigation. Thirty more left the company for unrelated reasons.

Despite the scope of the fraud, 61 employees involved in the scheme still remain on Amtrak’s payroll. In response, the company has increased oversight and employee training to prevent future abuse.

The investigation began when unusual billing patterns were flagged by an internal agent. This led to three New York-based medical providers with high volumes of Amtrak patients being scrutinized.

Undercover Operation Uncovers Bribes and Threats in Health Care Scam

In June 2021, an undercover agent posed as an Amtrak employee and visited acupuncturist Punson Figueroa. She had the agent sign dozens of blank treatment forms used to file false claims.

A month later, she handed the agent an envelope containing $1,000 in cash. Figueroa later pleaded guilty and was sentenced to supervised release, along with an order to repay over $9 million.

Two former Amtrak employees—Devon Burt and Hallum Gelzer—recruited participants and threatened one provider with violence. They pleaded guilty and agreed to pay back $1 million and $1.66 million respectively.

Other convicted participants include Dr. Muhammed Mirza, sentenced to 26 months and ordered to repay $1.37 million, and Regina Choi, a biller who admitted to filing false claims and bribing employees.

Source: nypost.com

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