Feds charge 4 people in a multimillion-dollar Amtrak health insurance scam

Feds charge 4 people in a multimillion-dollar Amtrak health insurance scam

Four people were arrested Thursday on charges they participated in a multimillion-dollar scam to defraud Amtrak by bribing employees of the rail agency to submit bogus claims to the Amtrak health insurance plan, authorities said.

Muhammad Mirza, 50, of Cedar Grove, Devon Burt, 49, of Blue Bell, Pennsylvania, and Hallum Gelzer, 43, of East Orange, were charged with conspiracy to commit health care fraud, according to US Attorney for New Jersey Philip R. Sellinger. Court papers identified Mirza as a doctor with offices in New Jersey and New York and list Burt as an Amtrak employee.

An acupuncturist, Punson Figueroa, 55, of Long Island City, New York, was charged with 15 counts of health care fraud in the scheme, according to court documents.

The four allegedly recruited Amtrak employees from New Jersey and New York to allow Mirza, Figueroa, and others to use their medical and insurance information to submit false claims.

“Mirza, Figueroa, and others benefitted from this scheme by receiving payments from the Amtrak health care plan for services that were never provided or that were medically unnecessary,” the US Attorney’s Office said in a statement.

Meanwhile, Gelzer and Burt received cash in return for allowing the health care providers to use their information to submit fraudulent claims and for recruiting others to the scam, according to documents filed in the case.

An undercover investigator posing as an Amtrak employee met with Figueroa at his New York office on June 17, 2021, authorities said. Figueroa had the undercover agent sign his name about 30 times for acupuncture and physical therapy purportedly received, but not to date the documents.

“Figueroa stated to the undercover agent that the undercover agent had good insurance, and that Amtrak has very good benefits,” the statement said. “Figueroa submitted or caused to be submitted false claims to Amtrak’s health care plan indicating that the undercover agent had visited providers at least seven times in May 2021, purportedly receiving acupuncture and physical therapy services.”

In fact, prosecutors said the undercover agent only visited Figueroa’s office one other time, on July 29, 2021. During the meeting, which was recorded with audio and video, Figueroa gave the undercover investigator an envelope filled with $1,000, court papers stated.

Figueroa used the undercover agent’s personal and insurance information to submit bogus claims to Amtrak’s health plan over 73 times, leading the plan to pay $31,840, according to the documents.

Authorities said the Amtrak health care plan paid at least $9 million from claims linked to providers connected to the fraud.

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Noah Cohen may be reached at ncohen@njadvancemedia.com.

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