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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
Investigative Reports
Date Issued
Agency Reviewed / Investigated
Report Title
Type
Location
Amtrak (National Railroad Passenger Corporation)
Medical Assistant Pleads Guilty to Multiple Charges in Health Care Fraud Scheme
Judy Azar, a medical assistant based in Los Angeles, pleaded guilty in U.S. District Court, Central District of California, on September 24, 2021, to health care fraud, bank fraud, identity theft and tax fraud. Our investigation found that Azar participated in a scheme to defraud health care benefit programs by using false and fraudulent pretenses in connection with the delivery of, and payment for, health care benefits and services.Azar forged a doctor’s signature to fraudulently authorize prescription refills and then sold a portion of the filled prescriptions to interested buyers. The buyers paid Azar with checks made payable to the doctor. Azar then forged the doctor’s signature to endorse the checks, which were then deposited in bank accounts controlled by Azar. As a result of the scheme, Amtrak’s insurance providers were fraudulently charged approximately $13,500.
DOJ Press Release: United States Reaches $842,500 Settlement with Two Public Universities and the North Carolina Commission on Volunteerism and Community Service to Resolve Alleged False Claims for AmeriCorps Funds
DOJ Press Release: West L.A. Man Pleads Guilty to Fraudulently Obtaining Approximately $9 Million in COVID-Relief Loans, Some of Which Was Gambled Away
An Amtrak Sheetmetal Worker Mechanic based in Beech Grove, Indiana, resigned from the company on September 14, 2021, following the release of our investigative report. Our investigation found that the former employee violated company policies by engaging in self-employment that interfered with his job duties and responsibilities. On some occasions, he used a personal leave of absence and leave granted under the Americans with Disabilities Act to operate his lawn care service.
Phong Hung Tran, a licensed physician and surgeon in the state of California, was sentenced in United States District Court, Southern District of California, on September 13, 2021, to time served, two years’ probation and 12 months of home confinement for conspiracy to commit honest services mail fraud and health care fraud.Our investigation found that Tran and other doctors arranged for and accepted kickback payments from suppliers of health care services and products. The kickback scheme involved the referral of prescriptions for medically unnecessary compounded drugs and other items that were reimbursed by health care benefit programs. As a result of the scheme, Amtrak’s insurance providers were fraudulently charged approximately $22,000. Criminal judicial proceedings for other defendants in this case are pending.
Suspected Violations of the Architect of the Capitol (AOC) “Government Ethics,” “Standards of Conduct,” “Authority and Responsibilities of the Office of Inspector General and Cooperation of AOC Employees” Policies and “Title 18, United States Code §1001 –
The OIG’s administrative investigation examined the circumstances surrounding the death of a veteran on the Edith Nourse Rogers Memorial Veterans Hospital campus in Bedford, Massachusetts (the medical center). Mr. Timothy White was a resident of the Bedford Veterans Quarters (BVQ), an independent living facility operated by Caritas Communities, Inc. (Caritas), in space leased to it through VA’s enhanced-use lease program. A month after Mr. White was reported missing, his body was found in the emergency exit stairwell of the building that houses the BVQ. This stairwell down the hall from his room was VA property and not leased to Caritas.The VA police department’s failure to locate Mr. White resulted in part from the police and others at VA not considering the veteran an at-risk missing patient, which would have required a stairwell search. The Veterans Health Administration and the Office of Security and Law Enforcement lacked clear guidance regarding the obligations of VA police to search for nonpatients reported missing on VA property.VA police also did not discover Mr. White in the stairwell because of an improper order by the then police chief to cease patrols of the building in which Mr. White was found. The OIG found that the VA police chief exceeded his authority as both VA policy and the lease required VA police to patrol VA property.Lastly, because medical center staff mistakenly believed the emergency exit stairwells were not VA space, they did not clean them. The confusion among medical center leaders and staff regarding the lease scope and VA’s obligations stemmed from a lack of clear guidance from the Office of Asset and Enterprise Management. Routine police patrols and stairwell cleanings likely would have led to Mr. White being found earlier.VA concurred with the OIG’s seven recommendations to improve policies and procedures.
Findings of Misconduct by Community Relations Service Senior Official for Violation of DOJ Information Technology Security Rules of Behavior for General Users
Joseph Kieffer, a marketer from Los Angeles, was sentenced on September 8, 2021, in U.S. District Court, Central District of California, to six months in prison, three years’ probation, a $10,000 fine, and he was ordered to pay restitution in the amount of $1,250,000 and a money judgment of forfeiture of $328,835. Kieffer previously pleaded guilty to paying kickbacks to marketers and some patients to obtain medically unnecessary compounded drugs, which allowed Fusion RX Compounding Pharmacy to bill health care providers for those drugs. Many of the prescription claims were reimbursed at rates much higher than average medications. The owner of Fusion Rx Compounding Pharmacy was also charged for his role in the scheme. Amtrak’s health insurance plan was fraudulently billed $17,000 as a result. Criminal judicial proceedings for other defendants are pending.
DOJ Press Release: Three South Florida Men Guilty of Conspiring to Launder Fraudulently Obtained Covid-19 Relief Money and Proceeds from Business Email Compromise Schemes
An Amtrak passenger conductor based in Florence, South Carolina, was terminated from employment on September 2, 2021, following his administrative hearing. Our investigation found that the former employee violated company policy by engaging in outside employment while on a medical leave of absence from the company and by being dishonest on his pre-employment physical exam form when responding to questions regarding previous injuries and hospitalizations.
Findings of Misconduct by a Bureau of Prisons Warden for Failing to Address a Lack of Heat in Housing Units, Failing to Maintain a Functioning Camera System Throughout the Facility, and Lack of Candor