A “bombshell probe” by Amtrak’s Office of the Inspector General (OIG) uncovered a massive scheme where employees exploited their health plans by colluding with corrupt doctors who filed fake claims, according to a report in the New York Post. 

The investigation began after an Amtrak agent noticed unusual billing patterns, according to the OIG. Agents discovered three New York health care providers with “questionable billings” and an unusually high number of Amtrak employees as patients.

According to the New York Post: 

“An undercover agent posed as an Amtrak employee in June 2021 and met with Punson Figueroa — an acupuncturist from Long Island City who told the agent her name was “Susie,” according to the OIG. At Figueroa’s office, she had the undercover agent sign about 30 undated papers for acupuncture and physical therapy treatments, the report said. Figueroa allegedly submitted the signed papers as fraudulent claims to Amtrak’s health care provider over the next few weeks. The undercover agent went back to Figueroa’s office the following month, and Figueroa handed them an envelope stuffed with $1,000 in cash.”

This case exposes the alarming scale and consequences of health care claim fraud. By exploiting medical billing systems and manipulating trusted relationships between providers and patients, certain individuals not only drained substantial resources from Amtrak’s health care fund but also from taxpayers who fund these systems. 

Ultimately, fraudulent schemes like this drive up insurance premiums, increase costs for employers and employees alike, and divert resources away from legitimate patient care, causing Americans across the country to suffer.