A minimum of 119 Amtrak workers and medical doctors took the railroad firm for a trip in a large $12 million well being fraud scheme, a watchdog discovered.
Amtrak’s Workplace of Inspector Normal (OIG) mentioned workers based mostly in Pennsylvania, Delaware, New Jersey, New York, Maryland, Connecticut and Washington, D.C., accepted money kickbacks from three healthcare providers in alternate for using their insurance coverage data and that of their dependents in a scheme from 2019 to 2022.
“The sheer quantity of workers who cavalierly participated on this scheme to steal Amtrak’s funds suggests not solely a critical lapse in fundamental ethics, however a troubling workforce tradition, no less than within the Northeast area, wherein blatant legal habits was one way or the other normalized,” mentioned Amtrak Inspector Normal Kevin H. Winters.
Fox Information Digital has reached out to Amtrak.
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Amtrak ran service between Chicago and Florida within the Nineteen Seventies. (Amtrak)
The healthcare suppliers used that worker data to file fraudulent and questionable medical claims for companies that had been by no means offered or not medically needed, the OIG mentioned. General, the taxpayer-funded railroad service’s well being plan was billed greater than $16 million and was bilked out of $12 million.
Of the 119 workers implicated, 28 retired or resigned on account of the OIG’s investigation, and 30 left the corporate for “different causes.” One other dozen workers have been criminally charged, and 7 have pleaded responsible and are awaiting sentencing.
Sixty-one are nonetheless on the job.
In a press release to Fox Information Digital, Amtrak mentioned it has taken “vital steps” to deal with medical insurance coverage fraud.
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An Amtrak practice at Penn Station in New York Metropolis. (Getty Photos)
“Like many employers, Amtrak calls on medical profit suppliers and insurers to do extra to determine suspicious exercise and cease medical insurance coverage fraud,” the corporate mentioned. “Amtrak strongly condemns this reprehensible act that occurred between 2019 and 2022 and is taking swift motion with all energetic workers concerned within the investigation.
“Whereas we proceed to work carefully with the OIG to determine and stamp out fraud, we additionally proceed to work on different initiatives to deal with this concern,” the assertion added. “Amtrak has carried out numerous measures to reinforce fraud prevention and empower workers to report suspected wrongdoing. These efforts embody growing oversight and strengthening efforts to eradicate fraudulent schemes.”

Canceled trains are displayed on an Amtrak departures board in Moynihan Prepare Corridor at Penn Station in New York Dec. 23, 2024. (Yuki Iwamura/Bloomberg by way of Getty Photos)
The OIG launched a probe when an agent observed uncommon billing patterns in stories by information analysts. Three New York healthcare suppliers with “questionable” billings who shared a excessive variety of Amtrak workers as sufferers had been recognized by investigators.
An secret agent posing as an Amtrak worker met with Punson Figueroa, aka “Susie,” an acupuncturist from Lengthy Island Metropolis, New York, June 16, 2021. Through the go to, Figueroa informed the agent to signal his identify 30 instances for service with out relationship the signatures, the OIG mentioned.
Figueroa then submitted alleged fraudulent claims to Amtrak’s healthcare plan, saying the agent had visited suppliers no less than seven instances in Might 2021 for acupuncture and bodily remedy. The agent visited Figueroa’s workplace once more on July 29, 2021, the place she allegedly handed him an envelope containing $1,000.
Figueroa continued to make use of the agent’s insurance coverage data to submit dozens of fraudulent claims to Amtrak’s healthcare plan, investigators mentioned.
Figueroa pleaded responsible to defrauding Amtrak’s healthcare plan, was sentenced to a few years of supervised launch and was ordered to pay restitution of $9.05 million. Two different healthcare suppliers and a medical biller have additionally pleaded responsible for his or her roles within the scheme.

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Michael DeNicola, a podiatrist from New York, pleaded responsible June 29, 2022, to conspiracy to commit well being care fraud, distribution of a managed substance and illegal possession of a gun. He has not but been sentenced.
Regina Choi, a medical biller from Woodside, New York, who beforehand labored for Figueroa, pleaded responsible to conspiracy to commit well being care fraud June 11, 2024, for submitting false and fraudulent claims to the Amtrak well being care plan and paying money kickbacks to Amtrak workers. Her sentence can also be pending.
In 2018 and 2019, OIG auditors issued separate stories that mentioned Amtrak might strengthen measures to determine fraudulent medical claims sooner. Each stories famous billing patterns indicative of potential fraud amongst lots of of suppliers, the OIG mentioned.
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