Over 100 Amtrak Staff Implicated in Insurance Fraud, Reports Watchdog

According to a new report from the Amtrak Office of the Inspector General, at least 119 present and past staff members colluded with medical professionals in New York to defraud Amtrak's health care plan of over $12 million. The report labels this as the largest employee scheme ever examined by the office.

"The massive number of personnel who nonchalantly participated in this fraud to siphon funds from Amtrak indicates not only a breakdown in ethical standards but also points to a concerning workplace culture, particularly in the Northeast, where open criminal activities were oddly accepted," stated Amtrak Inspector General Kevin H. Winters.

Amtrak is a commercial enterprise operating rail services across 46 U.S. states and employs more than 20,000 people. It also benefits from billions in federal funding.

In federal court, twelve Amtrak workers and three medical providers have faced legal charges due to their involvement in the fraudulent activities.

Devon Burt from Blue Bell, Pennsylvania, and Hallum Gelzer from East Orange, New Jersey, both Amtrak employees, allegedly collaborated with medical providers to entice other employees into the scheme, as per the report. They targeted Amtrak staff in areas including Pennsylvania, Delaware, New Jersey, New York, Maryland, Connecticut, and Washington, D.C.

Employees are accused of accepting financial incentives from healthcare providers in return for allowing the use of their insurance details. These details were allegedly manipulated to submit false claims for non-existent services.

In June 2023, Burt and Gelzer entered guilty pleas on charges of conspiracy to engage in health care fraud and conspiracy involving extortionate threats. Their agreements include Burt repaying $959,072 and Gelzer about $1.66 million.

Six additional workers have admitted guilt to charges of health care fraud conspiracy, according to the report. However, details about the prosecuting body and jurisdiction for these pleas remain unspecified.

The investigation notes that around 28 employees either retired or resigned, with an additional 30 leaving for other unknown reasons.

The scheme resulted in over $16 million billed to Amtrak's health care plan, with over $12 million paid out, as unveiled by the Office of the Inspector General.

The investigation began after an agent came across unusual billing patterns among the three medical providers in New York and observed a high number of overlapping Amtrak personnel as patients.

Amtrak has mentioned that they are contemplating disciplinary measures against the remaining 61 active employees linked to the fraud.

Amtrak, in a statement to CBS News, highlighted that it has implemented substantial measures to combat medical insurance fraud and urged both medical benefit providers and insurers to enhance their vigilance against suspicious activities.