NEWARK, N.J. – A New York doctor today admitted participating in a health care fraud scheme to defraud Amtrak, distribution of a controlled substance in furtherance of that scheme, and the unlawful possession of a firearm, U.S. Attorney Philip R. Sellinger announced.
Michael DeNicola, 59, pleaded guilty before U.S. District Judge Madeline Cox Arleo in Newark federal court to an information charging him with conspiracy to commit health care fraud, distribution of a controlled substance, and unlawful possession of a firearm.
According to documents filed in this case and statements made in court:
From 2019 to August 2021, DeNicola and his conspirators agreed to engage in a scheme to bill the Amtrak health care plan for fraudulent claims for services that either were never provided or were medically unnecessary. They would recruit Amtrak employees to participate in the scheme by paying them to allow the conspirators to use their patient and insurance information to submit false and fraudulent claims. DeNicola and his conspirators submitted false and fraudulent claims that caused Amtrak losses of more than $1.6 million.
DeNicola also provided oxycodone prescriptions to an individual in return for the individual’s agreement to allow his patient and insurance information to be used for the submission of fraudulent insurance claims. DeNicola provided oxycodone prescription to others at the direction of this individual and did so outside of the usual course of professional...
University of Rochester Medical Center and a former pathologist resolved a retaliation suit alleging URMC violated the False Claims Act by firing her for calling attention to federal grant fraud. ...