Cedar Grove, N.J.-based Muhammad Mirza, MD, pleaded guilty to defrauding Amtrak's health plan $1.4 million through submitting bills for procedures that were never performed or were not medically necessary, according to court documents.
From roughly April 2017 to June 2022, Dr. Mirza, along with podiatrist Michael Denicola, DPM, would recruit Amtrak employees and pay them to use patient and insurance information to submit fraudulent claims.
He also hired healthcare providers, including nurse practitioners, and used their national provider identity to submit fraudulent claims on behalf of the bribed Amtrak employees. Dr. Mirza repeatedly billed the Amtrak plan for procedures such as nerve conduction studies and arthrocentesis purportedly performed by employees who never actually performed the services.
Dr. Mirza pleaded guilty to one count of conspiracy to commit healthcare fraud. He faces a maximum of 10 years in prison and a $250,000 fine, or twice the gross gain or loss from the scheme, according to an April 26 news release from the Justice Department.