Two from NJ Charged in Massive Amtrak Health Care Fraud Scheme

Two people from New Jersey, along with two from New York, have been arrested for allegedly participating in a health care fraud scheme to defraud Amtrak by bribing Amtrak employees to allow people to submit fraudulent claims to its health insurance plan.

U.S. Attorney Philip Sellinger says 50-year-old Muhammad Mirza of Cedar Grove, NJ; 49-year-old Devon Burt of Blue Bell, PA; and 43-year-old Hallum Gelzer of East Orange, NJ; were charged with conspiracy to commit health care fraud. 55-year-old Punson Figueroa (a.k.a. "Susie Figueroa") of Long Island City, NY, was charged in the same complaint with 15 counts of health care fraud.

According to Sellinger's office,

From 2019 to the present, Mirza, Figueroa, Gelzer, Burt, and others recruited Amtrak employees – primarily from New Jersey and New York – to participate in the scheme through the offer of cash payments, in exchange for the employees agreeing to allow Mirza, Figueroa, and others to use their patient and insurance information to submit fraudulent 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. Gelzer, Burt, and others benefitted from this scheme by receiving cash payments from providers in return for allowing those providers to use their personal and insurance information to submit fraudulent claims and in return for recruiting others to participate in the scheme.

In total, the Amtrak health care plan paid around $9 million as a result of claims associated with providers connected to this scheme.

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All four appeared before a judge on Thursday and were released on a $200,000 unsecured bond.

If convicted, the conspiracy and health care fraud charges each carry up to ten years in prison and a $250,000 fine.

The public is reminded that charges are accusations and all persons are considered innocent until proven guilty in a court of law.