NEWARK, N.J. — Four people have been arrested and charged for their roles in a health-care fraud scheme that resulted in Amtrak paying at least $9 million in medical claims to those associated with the scheme.
A press release from the U.S. Attorney’s Office for the District of New Jersey says Muhammad Mirza, 50, of Cedar Grove, N.J.; Devon Burt, 49, of Blue Bell, Pa.; and Hallum Gelzer, 43, of East Orange, N.J. have been charged with conspiracy to commit health care fraud in Newark federal court. Punson Figueroa, 55, of Long Island City, N.Y., was charged with 15 counts of health care fraud.
The charges carry a maximum penalty of 10 years in prison and a $250,000 fine, or twice the gross gain or loss from the offense, whichever is greater.
The scheme involved bribing Amtrak employees to allow people to submit fraudulent claims to the Amtrak health insurance plan, according to documents filed in the case and statements made in court. Mirza, Figueroa, and others received payments from the health care plan for services that were never provided or were medically unnecessary; Gelzer, Burt, and others received cash for allowing providers to use their personal and insurance information to submit fraudulent claims, and for recruiting others to take part in the scheme.
An undercover officer visited the office of Figueroa in June 2021 and signed his name on documents about 30 times for services received, with the instruction not to date the documents, and submitted claims saying the agent had visited care providers seven times in May 2021 to receive acupuncture or physical therapy. In a second visit in July 2021, the officer received $1,000 from Figueroa, who continued to use the agency’s information to commit a total of 73 claims to the Amtrak health care plan. Those claims resulted in $31,840 in payments.
The investigation involved Amtrak’s Office of Inspector General, the U.S. Drug Enforcement Administration, the FBI, the U.S. Food and Drug Administration Office of Criminal Investigations, the U.S Postal Inspection Service, and the Amtrak Police Department.
Already been charged. Great job!
The insurance company did not flag multiple payments, multiple times for one name? Amtrak should get another insurer. Further, where are other scams that have been paid for? This is a madness that tax payers have to cover, but no one in the administration of Amtrak’s health plan will see an adverse consequence.
no need to worry the DEM do nothing District Attorneys will not prosecute anyway