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DOJ Enforcement Actions

					
The  is the principal federal agency authorized to enforce the laws and defend the interests of the United States. As such, it oversees the enforcement of the False Claims Act, the foundation of the American whistleblower system, as well as numerous other laws.


The agency traces its origins to the Judiciary Act of 1789 which created the Office of the Attorney General, and the 1870 Act to Establish the Department of Justice, which established the agency as “an executive department of the government of the United States” with the Attorney General as its head.


The agency is comprised of numerous divisions with the Civil Division and in some instances, the Criminal Division, overseeing investigations and prosecutions under the False Claims Act. The  of the federal district where the False Claims Act case is filed also plays a key role in False Claims Act enforcement.


Below are summaries of recent DOJ settlements or successful resolutions under the False Claims Act as well as other successful prosecutions for fraud and misconduct. If you believe you have information about fraud which could give  rise to a claim for a whistleblower reward, please contact us to speak with one of our experienced whistleblower attorneys.

				

			

			
						
					
			

	
		
		

			

				
				
February 11, 2019

				 North Greenville University (NGU) in South Carolina has agreed to pay $2.5 million to settle claims that it violated Title IV of the Higher Education Act, as well as the False Claims Act, by improperly compensating student recruiters with bonuses while receiving federal student aid. The alleged fraud was exposed by Maurice Shoe, co-owner of a recruiting company partially owned by NGU; Shoe will now receive $375,000 of the government’s recovery. 				 					 

						
Tagged in:
													  Education Fraud, 
													  FCA Federal, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 12, 2019

				 Jefferson Medical Associates, a Laurel-based physicians group, and neurologist, Dr. Aremmia Tanious, will pay the United States $817,635.06 to settle allegations under the False Claims Act regarding Medicare overpayments. The government’s investigation discovered that from 2012 to 2014, Jefferson Medical Associates and Dr. Tanious allegedly did not return overpayments they received on claims from Medicare. It is further alleged that from February 1, 2013, through June 30, 2017, Jefferson Medical Associates and Dr. Tanious allegedly used multiple medical codes when billing Medicare but the medical documentation did not support those billing practices. 

 

 				 					 

						
Tagged in:
													  FCA Federal, 
													  Medical Billing Fraud, 
													  Medicare, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 8, 2019

				 Two executives from the South Carolina Early Autism Project (SCEAP) have been convicted of causing false statements to be submitted to Medicare and TRICARE and causing them to be overcharged by millions of dollars. According to statements by SCEAP employees, co-founder Ann Davis Eldridge and executive Angela Breitweiser Keith instructed employees to include travel and wait time in their billing in order to inflate time spent providing services. To further incentivize this practice, they implemented billing goals that had to be met in order to qualify for bonuses such as gift cards and vacations, all paid for by the company. Since then SCEAP has repaid almost $9 million, and as part of their plea agreement, both Keith and Eldridge will serve 1-year sentences. 				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Medical Billing Fraud, 
													  Medicare, 
													  Other Government Health Programs, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 8, 2019

				 In connection with alleged fraud on a multi-billion dollar Department of Energy contract, the United States has filed a False Claims Act complaint against Mission Support Alliance LLC (MSA), Lockheed Martin Services Inc. (LMSI), Lockheed Martin Corporation (LMC) and Jorge Francisco Armijo, currently VP of LMC but formerly president of MSA. The complaint alleges that defendant LMSI violated the FCA by submitting false statements about its profits to order to inflate its billing rate. The complaint also alleged that, in violation of the Anti-Kickback Act, defendant LMC paid Armijo and other MSA executives more than $1 million in order to win a $232 million subcontract to clean up the Hanford nuclear waste site in Washington State. ; 				 					 

						
Tagged in:
													  Bribery and Bid-Rigging, 
													  Contract Non-Compliance, 
													  Environmental Fraud, 
													  FCA Federal, 
													  Pricing Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 8, 2019

				 A Texas-based marketing company, One Source Healthcare Organization, and its owner, James Paul Adams, have agreed to pay $339,412.50 to resolve allegations that it violated the Anti-Kickback Statute in accepting illegal payments from a compounding pharmacy to market their drug. Because the payments resulted in false claims being paid by Medicare and TRICARE, they were also alleged to be in violation of the federal False Claims Act. Two men affiliated with the compounding pharmacy, Oklahoma-based OK Compounding, LLC, were previously indicted on similar charges. 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Compounding Pharmacy Fraud, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicare, 
													  Other Government Health Programs, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 7, 2019

				 The founder and president of an online gaming company has been arrested and charged with securities fraud for allegedly defrauding more than 50 investors of about $9 million in a scheme that ran from 2013 to 2017. To execute the fraud, Robert Alexander allegedly lied to investors about his professional background, Kizzang LLC's financial condition, and the expected returns on investment. He then allegedly appropriated $1.3 million for his own use. If convicted, he faces a maximum sentence of 40 years in prison and millions in fines. ; 				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Financial and Investment Fraud, 
													  Misrepresentations, 
													  Securities Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 7, 2019

				 Six people associated with a string of substance abuse treatment centers have been indicted for defrauding Ohio's Medicaid program of over $31 million. Ryan Sheridan, the owner and operator of the businesses, along with Jennifer Sheridan, Kortney Gherardi, Lisa Pertee, Thomas Bailey, and Arthur Smith, allegedly submitted claims that were false on a number of fronts, including but not limited to: billing without proper documentation, for medically unnecessary services, provided by unqualified persons, and upcoded to a more costly service. Altogether, 134,744 false claims were submitted for more than $48.5 million in services. 				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Improper Medical Personnel, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Medical Billing Fraud, 
													  Upcoding, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 7, 2019

				 A former bus driver with the New York Metropolitan Transit Authority has been sentenced to 20 months in prison for defrauding the authority's health benefit plan of $2.8 million. Enver Kalaba, who was recruited into the scheme by former bus driver Christopher Frusci, worked on behalf of an unnamed company to pay bribes to fellow MTA employees in exchange for medically unnecessary prescription compounded medications. For each prescription for medications such as pain creams, scar creams, and metabolic supplements, Kalaba and Frusci paid $100. As part of his sentence, Kalaba must now forfeit $138,630 in fraudulent earnings and pay $2.9 million in restitution. Frusci is scheduled to be sentenced next month. 				 					 

						
Tagged in:
													  Compounding Pharmacy Fraud, 
													  Criminal Proceedings, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Other Government Health Programs, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 6, 2019

				 An electronic health records provider, Greenway Health LLC, will pay $57.25 million to settle a False Claims Act case brought by the U.S. alleging that Greenway fraudulently obtained certification that is product, Prime Suite, complied with HHS requirements and therefore that healthcare providers using Prime Suite could receive payments under the Medicare and Medicaid EHR Incentive Program.  Greenway allegedly modified the software tested by the certification body to make it appear that Prime Suite was performing as required when it was not, and failed to correct known errors in the software.  In addition, the government alleged that Greenway violated the Anti-Kickback Statute by providing incentives including payments to clients to recommend Prime Suite. Greenway entered into a five-year Corporate Integrity Agreement which includes an independent monitoring process.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Electronic Health Records, 
													  FCA Federal, 
													  Healthcare Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 6, 2019

				 Families United Services, Inc. (FUS) and owner Pamela McKenzie have agreed to pay $645,000 to settle allegations of defrauding Georgia's Medicaid program from 2010 to 2012 by submitting claims for unprovided mental health services. As part of the settlement, FUS has been excluded from participating in federal healthcare programs for a period of five years. 				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medical Billing Fraud, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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