New York acupuncturist sentenced to prison for role in bilking Amtrak’s health care plan of $9 million

September 26, 2024

NEWARK, N.J. — A New York acupuncturist was sentenced Tuesday to 34 months in prison for participating in a $9 million health care fraud scheme to defraud Amtrak, according to the U.S. Attorney’s Office, District of New Jersey.

Punson Figueroa, aka “Susie,” 58, of Long Island City, New York, was also sentenced to 3 years’ supervised release and was ordered to pay restitution of $9.05 million.

According to court documents, Figueroa and her coconspirators engaged in a scheme from around January 2019 through around June 2022 to bill Amtrak’s health care plan for services that weren’t provided and were medically unnecessary. Figueroa recruited and conspired with dozens of Amtrak employees, providing them with cash in return for allowing her to use their personal and insurance information to submit false and fraudulent health insurance claims. Figueroa pleaded guilty on March 7, 2024, to an information charging her with conspiracy to commit health care fraud.

“We remain fully committed to bringing justice to health care providers who target Amtrak’s health care plans as well as Amtrak employees who collude with them,” said Amtrak’s Inspector General, Kevin H. Winters. “We hope this case serves as a deterrent for health care providers and Amtrak employees who may choose to engage in such schemes, and we ask anyone who suspects or observes such fraud to report it to our fraud, waste, and abuse hotline.”

On June 16, 2021, an undercover law enforcement agent posing as an Amtrak employee met with Figueroa at Figueroa’s office in New York. Figueroa instructed the undercover agent to sign his name about 30 times for services received and instructed the undercover agent not to date the signatures. Figueroa caused false claims to be submitted 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. The undercover agent visited Figueroa’s office on only one other occasion, on July 29, 2021. At this meeting, Figueroa handed the undercover agent an envelope filled with $1,000. Thereafter, Figueroa continued to use the undercover agent’s personal and insurance information to submit dozens of fraudulent claims to the Amtrak health care plan.

As part of the broader health care fraud case, ten current and former Amtrak employees were each charged by indictment on June 20, 2024, with conspiracy to commit health care fraud for allegedly accepting cash kickbacks from health care providers as part of the scheme. In addition, a medical biller, Regina Choi, 39, of Woodside, New York, who previously worked for Figueroa, pleaded guilty to conspiracy to commit health care fraud on June 11, 2024, for submitting false and fraudulent claims to the Amtrak health care plan and paying the cash kickbacks to Amtrak employees.

The scheme also included an acupuncturist, Michael DeNicola, a podiatrist from New York, and Muhammad Mirza, a medical doctor from New Jersey. Mirza was sentenced on May 7, 2024, to 26 months in prison, and Denicola previously pleaded guilty to conspiracy to commit health care fraud, distribution of a controlled substance, and unlawful possession of a firearm. A former Amtrak employee, Devon Burt, and co-conspirator Hallum Gelzer each previously pleaded guilty to conspiracy to commit health care fraud and conspiracy to communicate extortionate threats. DeNicola, Burt, and Gelzer are pending sentencing. In total, Amtrak’s health care plan was fraudulently billed for $11 million, of which Figueroa caused Amtrak to pay out over $9 million in false and fraudulent insurance claims.

In addition to the Amtrak Office of Inspector General, the case was supported by the Drug Enforcement Administration, and the Amtrak Police Department.

Reports of fraud, waste, or abuse; criminal or unethical acts affecting Amtrak’s property or operations; or mismanagement in Amtrak programs or operations can be made 24 hours a day via the Amtrak OIG Hotline at 1-800-468-5469 or online at https://direc.to/hPAu.

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