An acupuncturist in Los Angeles, California, allegedly recruited employees of Amtrak to visit her clinic for the purpose of making fraudulent claims to the national rail operator’s health care plan. She then reportedly funneled the funds into a bank account opened in the name of a shell company, as well as other accounts opened in relatives’ names.
In October, the acupuncturist pleaded guilty in federal court to one count of money laundering and one count of health care fraud. Earlier this month, she received a sentence of 30 months in federal prison. Additionally, she must pay restitution to Amtrak in the amount of $2,683,903.
The U.S. Attorney’s Office claims that fraud was the basis of the acupuncturist’s entire business model. Among the many allegations against her are that she billed the health plan for services that were not medically necessary (e.g., facials and massages), for injuries that she knew the plan did not cover and for acupuncture services that clients never received. She also reportedly waived co-insurance and co-pays for patients in defiance of the terms of the health plan. She allegedly billed the plan for services provided to non-employees of Amtrak in the name of actual employees and falsely billed existing patients as new patients because the reimbursement rate was higher.
The alleged scheme took place over the course of seven years, during which time the acupuncturist reportedly billed the health care plan for over $7 million, rivaling amounts billed by large research hospitals. Licensed medical professionals facing charges of health care fraud may wish to contact a defense attorney.
