By: Tracie Carter
A former New York-based podiatrist has been sentenced to federal prison for participating in a widespread insurance fraud operation involving Amtrak employees, illegally distributing prescription opioids, and unlawfully possessing a firearm.
According to information released by the U.S. Department of Justice, Michael DeNicola, 64, received a 32-month prison sentence for his involvement in a scheme that resulted in more than $11 million in fraudulent payments from Amtrak’s health care plan.
U.S. District Judge Madeline Cox Arleo imposed the sentence in Newark federal court, ordering DeNicola to serve three years of supervised release following his imprisonment.
He was also directed to pay more than $1.6 million in restitution and forfeit over $1.3 million.
Federal prosecutors said DeNicola worked with several individuals between 2019 and August 2021 to submit fraudulent medical insurance claims for treatments that were either unnecessary or never performed.
Investigators determined that participants recruited Amtrak employees by offering cash payments in exchange for access to their personal medical and insurance information.
That information was then used to generate fraudulent billing claims submitted to Amtrak’s employee health care plan.
Authorities said DeNicola’s involvement alone resulted in more than $1.6 million in losses to the insurance program.
The investigation also uncovered a separate arrangement involving the illegal distribution of prescription painkillers.
Federal officials said DeNicola supplied oxycodone prescriptions to an individual who agreed to provide insurance information for fraudulent billing purposes.
DeNicola also issued prescriptions to other individuals at that person’s direction, despite having no legitimate medical justification for doing so.
Between April 2017 and February 2018, prosecutors determined that DeNicola issued 64 oxycodone prescriptions outside the accepted standards of medical practice.
Investigators additionally established that DeNicola unlawfully possessed a firearm in September 2019 despite having a prior criminal conviction that prohibited him from possessing one.
DeNicola pleaded guilty on June 29, 2022, to conspiracy to commit health care fraud, unlawful distribution of controlled substances, and unlawful firearm possession.
Federal authorities described the broader Amtrak fraud investigation as an extensive operation involving dozens of railroad employees and multiple medical providers.
Prosecutors said participating health care professionals distributed hundreds of thousands of dollars in illegal payments to employees who helped facilitate fraudulent insurance claims.
The investigation has led to criminal charges against 19 individuals, including DeNicola, all of whom have pleaded guilty to conspiracy to commit health care fraud.
Authorities said the fraudulent billing associated with medical providers connected to the scheme resulted in more than $11 million in payments from Amtrak’s health care plan.