WASHINGTON — Seventeen Amtrak employees in the Northeast have resigned in connection with an investigation by Amtrak’s Office of Inspector General into alleged health care fraud.
The employees who have resigned are based at New York Penn Station or an Amtrak base in New Jersey. They include two gang foremen, four linemen, three truck drivers, six welders, a trackman, and an electronic technician, the Office of Inspector General said in a press release today (Wednesday, Oct. 16). Five members of that group are among 10 people indicted in June as a result of the investigation into conspiracy to commit health care fraud.
According to the investigation, current and former Amtrak employees submitted false claims of more than $11 million in claims between 2019 and 2022 for services that were never provided and were medically unnecessary, receiving kickbacks from health care providers for their participation.
In the most recent legal action resulting from the case, New York acupuncturist Punson (Susie) Figueroa was sentenced to 34 months in prison in September, along with three years’ supervised release, and ordered to pay $9.05 million in restitution. She had entered a guilty play in March to conspiracy to commit health car fraud. According to the Office of Inspector General, in a June 2021 visit to Figueroa’s office, an undercover officer was instructed to sign his name about 30 times to documents for services received but not to date those signatures; in a subsequent visit, he received an envelope with $1,000. Figueroa used those documents to submit fraudulent claims.
“We remain fully committed to bringing justice to health care providers who target Amtrak’s health care plans as well as Amtrak employees who collude with them,” Amtrak’s Inspector General, Kevin H. Winters, said following Figueroa’s sentencing. “We hope this case serves as a deterrent for health care providers and Amtrak employees who may choose to engage in such schemes, and we ask anyone who suspects or observes such fraud to report it to our fraud, waste, and abuse hotline.
Figueroa joined a mounting number of suspects in the case who have entered guilty pleas and been sentenced. In June, a biller for Figueroa, Hyunji Choi of Woodside, N.Y., pleaded guilty to conspiracy to commit health care fraud. Before that, a New Jersey doctor, Muhammed Mirza, was sentenced to 26 months in prison earlier this year for his role in the case [see “New Jersey doctor sentenced …,” Trains News Wire, May 7, 2024]. Two other individuals, former Amtrak employee Devon Burt and Hallum Gelzer, pleaded guilty in June 2023 to charges of conspiracy to commit health care fraud and conspiracy to communicate extortion threats; as part of their guilty pleas, they agreed to pay restitution of $959,072 and approximately $1.66 million respectively. Also, a New York podiatrist, Michael DeNicola, pleaded guilty in 2022 to conspiracy to commit health care fraud, distribution of a controlled substance in furtherance of that scheme, and unlawful possession of a firearm. His sentencing is pending.
Amtrak said in a statement that it “strongly condemns this reprehensible act uncovered by the OIG investigation. We regularly monitor for fraudulent payments and have challenged our healthcare providers to do better at uncovering and stopping these fraudulent schemes. This investigation sends a strong message to anyone who steals from Amtrak: you will be caught, and there will be consequences.”
Third Paragraph, “She entered a guilty play”.