At least 119 Amtrak employees and doctors took the railroad in a massive $12 million health fraud scheme, a watchdog found.
The Office of Inspector General Amtrak (OIG) said employees based in Pennsylvania, Delaware, New Jersey, New York, Maryland, Connecticut and Washington, D.C. received cash rebates from three health care providers in exchange for use of their insurance information and the use of dependents from 2019 to 2022.
"The huge number of plans to steal the program to steal Amtrak funds not only shows a serious mistake in basic ethics, but also, at least in the Northeast, the troubled workforce culture has been normalized in some way."
Fox News Digital has contacted Amtrak.
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In the 1970s, Amtrak served between Chicago and Florida. (Amtrak)
The healthcare provider uses the employee information to make fraudulent and suspicious medical claims for services that have never been provided or are not medically provided, OIG said. Overall, taxpayer-funded railroad airline health plans charge more than $16 million and are charged for $12 million.
Of the 119 employees implicated, 28 retired or resigned due to OIG's investigation, while 30 left the company for "other reasons". More than a dozen other employees have been criminally charged, and seven employees have pleaded guilty and are awaiting a verdict.
Sixty-one is still working.
Amtrak said in a statement to Fox News Digital that “important steps” have been taken to address Medicare fraud.
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Amtrak train at Penn Station in New York City. (Getty Image)
“Like many employers, Amtrak calls on health care providers and insurers to do more to identify suspicious activities and stop health insurance fraud,” the company said. “Amtrak strongly condemned this reprehensible behavior that took place between 2019 and 2022 and is taking quick action with all active employees involved in the investigation.
"Although we continue to work closely with OIG to identify and eliminate fraud, we also continue to take other plans to address this issue," the statement added. "Amtrak has taken various measures to enhance fraud prevention and empower employees to report suspicious misconduct. These efforts include increased oversight and enhanced efforts to eliminate fraudulent programs."
The cancelled train was displayed on the Amtrak Departure Committee at the Moynihan Train Hall at Pennsylvania Station in New York on December 23, 2024. (Yuki Iwamura/Bloomberg via Getty Images)
OIG launched the investigation when the agency noted unusual billing patterns in the data analyst's report. Investigators identified three New York healthcare providers who shared a large number of Amtrak employees.
OIG said a secret agent who pretended to be an Amtrak employee met with Punson Figueroa, an acupuncturist from Long Island, New York, June 16, 2021.
Figueroa then filed suspected fraudulent claims against Amtrak's health plan, saying the agent visited at least seven times in May 2021 for providers offering acupuncture and physical therapy. The agent visited Figueroa's office again on July 29, 2021, and she allegedly handed him an envelope containing $1,000.
Investigators said Figueroa continues to use the agent's insurance information to file dozens of fraudulent claims to Amtrak's healthcare program.
Figueroa pleaded guilty to cheating Amtrak's medical plan, was sentenced to three years of supervised release and ordered to pay $9.05 million in damages. Two other health care providers and one health care expenses have also pleaded guilty for their role in the program.
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Michael Denicola, a podiatrist from New York, pleaded guilty on June 29, 2022, demanding conspiracy to commit health care fraud, distribute controlled substances and illegal possession of firearms. He has not been sentenced yet.
Medical bills from Woodside, New York, Regina Choi, who previously worked in Figueroa, pleaded guilty and conspired to commit health care fraud on June 11, 2024, as he filed false and fraudulent claims against Amtrak health care programs and paid cash to Amtrak employees. Her sentences are waiting.
In 2018 and 2019, OIG auditors issued separate reports saying Amtrak could strengthen measures to determine fraudulent medical claims as soon as possible. OIG said both reports point to billing patterns, indicating that hundreds of providers are likely to be fraudulent.