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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.

				

			

			
						
					
			

	
		
		

			

				
				
August 20, 2018

				 The owner of an ambulance company has been convicted of defrauding Medicare by submitting claims for over $3 million in unprovided or unnecessary transport services. Anthony Nwosah of Tonieann EMS and Rosenberg EMS also admitted to falsifying and instructing others to falsify transport records, as well as submitting some under the name of an EMT who didn’t even work for him. He received $1,094,260 before the fraud was uncovered, and at his sentencing in November, he stands to receive a $250,000 fine and ten year sentence. 				 					 

						
Tagged in:
													  Ambulance, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medical Billing Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 16, 2018

				 Lincare, Inc—one of the largest home providers of respiratory therapy products and services in the nation—has paid $5.25 million to settle a suit filed by whistleblower Brian Thomas. In 2015, the former billing supervisor accused the company of violating the Anti-Kickback Statute and False Claims Act over a period of six years by unlawfully waiving or reducing fees paid by Medicare Advantage recipients and submitting false claims for reimbursement. Thomas will receive $918,750 for his role in exposing the alleged fraud. 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medical Billing Fraud, 
													  Provider Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 15, 2018

				 A Florida landlord has paid $50,000 to end an investigation under the False Claims Act that he improperly charged certain low income tenants whose rents were subsidized by a Department of Housing and Urban Development (HUD) program. In choosing to participate in and receive subsidies from the Housing Choice Voucher/Section 8 (HCV) program, Edward Daniel had agreed to charge no more than was authorized by the local public housing agency. Instead, he allegedly charged unauthorized parking fees and excessively high rents, and quietly received double subsidies for overlapping periods from various public housing authorities. 

				 					 

						
Tagged in:
													  FCA Federal, 
													  Grant and Research Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 15, 2018

				 Post Acute Medical, LLC has agreed to pay $13,031,502 to the United States, $114,016 to Texas, and $22,482 to Louisiana to settle allegations brought on by whistleblower Douglas Johnson that it violated the Anti-Kickback Statute, Physician Self-Referral Law, and state and federal False Claims Acts. The operator of long-term care and rehabilitation hospitals nationwide was accused of cultivating "reciprocal referral relationships" with outside healthcare providers and then billing Medicare and Medicaid for services that arose from those relationships. For his role in exposing the alleged fraud, Johnson will receive a cut of the federal government's share totaling $2,345,670. 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  FCA State, 
													  Hospital Fraud, 
													  SNF, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 14, 2018

				 An Illinois pharmacist, Steven Gibson, has pleaded guilty to fraudulently billing Medicare, Medicaid, and private insurance companies for unauthorized and often expensive prescriptions that were never intended to be dispensed to any patient. The reimbursements he received eventually netted him over $630,000—as well as the prospect of a $250,000 fine and ten years in prison. 				 					 

						
Tagged in:
													  Medical Billing Fraud, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 14, 2018

				 In the largest civil penalty imposed by the Justice Department for FIRREA violations leading up to the 2008 financial crisis, the Royal Bank of Scotland Group plc (RBS) will pay $4.9 billion to resolve claims that it knowingly misled investors of its residential mortgage-backed securities (RMBS), including Fannie Mae and Freddie Mac. According to a statement of facts included with settlement details, RBS knew from its own reviews that its loans carried a high risk of default but failed to disclose that to investors. Furthermore, it allowed its due diligence process to become a total sham by not requiring that loan originators correct errors, instructing due diligence vendors to waive defects, and self-imposing caps on the number of faulty loans it removed from a RMBS. ; 				 					 

						
Tagged in:
													  Financial Institution Fraud, 
													  FIRREA, 
													  Housing and Mortgage Fraud, 
													  Misrepresentations, 
													  Securities Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 13, 2018

				 Nurse practitioner Sandra Haar, founder and chief executive officer of Horisons Unlimited, a non-profit provider of health and dental services in Merced, California, pleaded guilty to health care fraud and conspiracy to receive kickbacks.  Haar's scheme billed for services that were not rendered or were medically unnecessary, even submitting bills for office visits with doctors when, in fact, patients were met in local parking lots and given Suboxone, an opioid medication, in plastic baggies.   Haar also received thousands in kickbacks from a laboratory in exchange for sending Horisons patients to the lab.   (later sentencing and civil settlement here)				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Healthcare Fraud, 
													  Medical Billing Fraud, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 10, 2018

				 An Illinois personal assistant, Betsy Gutowski, has pleaded guilty to filing fraudulent Medicaid reimbursement claims for work purportedly performed for a client under the Home Services Program, which is designed to keep clients out of nursing homes and in their own homes. At the time of the fraud, which spanned the year 2012, the client was in fact hospitalized or living in a nursing home, yet Gutowski billed for and received payments totaling $4,036.73. She now faces a possible maximum sentence of 10 years in prison and a $250,000 fine. 				 					 

						
Tagged in:
													  Home Health and Hospice, 
													  Medical Billing Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 10, 2018

				 Trinity Medical Pharmacy, LLP and several members of its leadership have agreed to pay $2,244,270.14 to settle allegations that it violated the False Claims Act by giving illegal kickbacks to patients and providers, billing TRICARE and other government programs for medical reimbursement claims arising from those kickbacks, and failing to disclose information that would have barred it from becoming a provider for Express Scripts, which provides pharmaceutical services for TRICARE. 				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 8, 2018

				 The former CEO of Wellco Enterprises, Inc., Vincent Lee Ferguson, was sentenced to 41 months in federal prison for his role in a scheme to sell boots to the Department of the Defense and others as "Made in the U.S.A.," when the boots were, in fact, made in China.  The company instructed its Chinese manufacturing facility to include tear-away "Made in China" labels on the boot uppers, and then instructed employees at Wellco's New Jersey facility to remove the labels.  The company sold over $8 million in fraudulently-marked boots.  				 					 

						
Tagged in:
													  Defense Contract Fraud, 
													  Government Procurement Fraud, 
													  Trade Agreements, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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