By: Richard L. Smith
An Amtrak employee has pleaded guilty to participating in a widespread health care fraud scheme that defrauded the company’s health insurance plan of millions of dollars, according to information released by the U.S. Department of Justice.
Rodolfo Rivera, 41, of Clayton, Delaware, admitted his involvement in the scheme before U.S. District Judge Madeline Cox Arleo in Newark federal court.
He was charged with conspiracy to commit health care fraud alongside nine co-conspirators, including other Amtrak employees from New Jersey, New York, Pennsylvania, and Connecticut.
Court documents and statements reveal that between January 2019 and June 2022, Rivera and his co-conspirators arranged to receive cash kickbacks from health care providers in exchange for allowing false and medically unnecessary claims to be billed to Amtrak's health insurance plan.
The fraudulent claims submitted on behalf of Rivera, his dependent, and other Amtrak employees he recruited cost the health plan more than $2 million. In total, the scheme resulted in over $11 million in fraudulent reimbursements.
Rivera reportedly received thousands of dollars in kickbacks from health care providers, including acupuncturist Punson Figueroa and podiatrist Michael DeNicola.
Figueroa previously pleaded guilty to conspiracy to commit health care fraud and was sentenced in September 2024 to 34 months in prison.
DeNicola also pleaded guilty in 2022 and awaits sentencing.
Rivera now faces up to 10 years in prison and a $250,000 fine for the health care fraud conspiracy charge. His sentencing is scheduled for June 26, 2025.
This case is part of ongoing efforts to combat health care fraud, which prosecutors say undermines public trust and increases costs for legitimate services.
The investigation remains active.