Federal prosecutors in New Jersey say the Amtrak health care plan paid more than $11 million in fraudulent claims after health care providers paid dozens of Amtrak employees cash for their personal and insurance information. Nineteen people have pleaded guilty, and three more were sentenced this week. The U.S. Attorney’s Office for the District of New Jersey said in its Oct. 8 announcement that the claims were for services that were never provided or were not medically necessary.

How the billing worked

According to prosecutors, other conspirators recruited Amtrak employees and paid them cash for the details needed to submit false claims to the plan. The overall scheme involved dozens of employees and multiple providers, who paid hundreds of thousands of dollars in cash kickbacks. The providers then billed the Amtrak plan for care that was never given or was not medically necessary, and the plan paid.

All 19 people prosecuted have pleaded guilty to conspiracy to commit health care fraud, U.S. Attorney Robert Frazer’s office says. The Amtrak Office of Inspector General and the Amtrak Police Department investigated, with James Harper, the inspector general’s special agent in charge, and James Cook, the police chief, credited in the releases.

For workers in a company health plan, the part that matters is how ordinary the first step was. Nobody had to hack a system: employees handed over their own insurance details for cash, and the plan then paid claims that used them. The people most affected are Amtrak employees and their families covered by the plan, and anyone else on an employer health plan, where each statement lists care that was supposedly given.

The $11 million loss and the 19 guilty pleas are the totals prosecutors repeated in each of this week’s sentencing announcements.

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The podiatrist who got 32 months

Michael DeNicola, 64, a podiatrist formerly based in New York, was sentenced on Oct. 7 to 32 months in prison and three years of supervised release, the U.S. Attorney’s Office said in its release on the case. He was also ordered to pay restitution of more than $1.6 million and to forfeit more than $1.3 million. Claims tied to him cost the plan more than $1.6 million, from a scheme that ran from 2019 to August 2021.

Prosecutors say DeNicola gave oxycodone prescriptions to a person in exchange for that person’s agreement to let his patient and insurance information be used for fraudulent claims, and wrote prescriptions for others at that person’s direction. He issued 64 such prescriptions between April 2017 and February 2018. DeNicola pleaded guilty in June 2022 to conspiracy to commit health care fraud, unlawful distribution of controlled substances and unlawful possession of a firearm.

The former Amtrak employee who got 20 months

Devon Burt, 53, of Blue Bell, Pennsylvania, a former Amtrak employee, was sentenced on Oct. 7 to 20 months in prison and two years of supervised release, with restitution of $959,072, according to the U.S. Attorney’s Office. Prosecutors say he worked with providers to recruit other Amtrak employees. He received cash for letting them use his information and that of his dependents, and more cash for bringing in others. The plan paid about $959,072 on claims tied to him.

Burt also pleaded guilty to conspiracy to communicate extortionate threats. Prosecutors say that from about April to June 2022 he and another conspirator used calls and texts to suggest a participating provider would be hurt unless paid several thousand dollars. The release does not say how much Burt received in kickbacks.

The physical therapist who got 15 months

Jaekwan Lee, 42, of Flushing, New York, a licensed physical therapist, was sentenced on Oct. 8 to 15 months in prison and two years of supervised release, with restitution of $841,666. Prosecutors say that from January to June 2022 he let his license and business bank accounts be used to bill the plan for services never provided, in exchange for a share of the proceeds. He pleaded guilty in May 2026. Assistant U.S. Attorney Katherine M. Romano is the prosecutor on the cases.

The three restitution figures cover each defendant’s own claims, so they are far smaller than the $11 million total for the scheme. Together they come to roughly $3.4 million of the more than $11 million the plan paid.

Spotting billing for care that never happened

The cases show what the fraud looked like from the plan’s side: claims for visits, treatments or services that did not occur, submitted using real members’ details. The practical step for any plan member is to read the statements the plan sends and flag any provider, date or service that does not match care actually received.

Amtrak employees and contractors can report suspected fraud to the Amtrak Office of Inspector General, which takes reports through an online complaint form around the clock and allows anonymous reports, though the office warns anonymity can limit an investigation. Useful details to include are the person or organization involved, dates, the program affected and any documents. Medicare and Medicaid fraud goes instead to the HHS Office of Inspector General at 1-800-HHS-TIPS.

The releases show where the cash-for-details arrangement ended for these defendants: prison sentences and restitution orders.

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This article was produced with AI assistance and edited for accuracy against the sources linked above.