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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.

June 22, 2018

Dr. Kelly Robinett and Kingsley Nwanguma were each convicted of multiple counts of conspiracy to commit health care fraud and health care fraud. Joy Ogwuegbu was also convicted of four counts of health care fraud. The conviction were related to a scheme by the three to overbill Medicare for medically unnecessary home health services that in many cases were not provided. The scheme billed Medicare $11.3 million for home health care services pursuant to certifications signed by Robinett and approximately $1 million related to medically unnecessary home health services. Sentencing has not yet been scheduled.

June 22, 2018

Tax preparers Joseph Racine and Arnouse Merlien pled guilty to conspiracy to violate the Internal Revenue Code by falsely claiming tax credits and deductions for their clients. Racine and Merlien defrauded taxpayers of over $3.5 million. The investigation showed that Racine and Merlien improperly claimed the tax credits and deductions for their clients to increase the amount of fees they could charge their clients.

June 22, 2018

David Laughton, a New Hampshire resident, has pleaded guilty to theft of public money. Laughton collected his deceased mother’s checks from the Social Security Administration and the Pension Benefit Guaranty Corporation for over a decade. In total, he collected over $180K of money meant for his mother.

June 21, 2018

Livingston Regional Hospital, a healthcare provider outside of Nashville, has paid $784K to settle FCA allegations that it improperly billed Medicare Part A for inpatient psychiatric care that was not medically necessary. The allegations were first brought forward by two whistleblowers who will receive a $156K reward.

June 21, 2018

Jasmin Polanco, a Boston-based real estate lawyer, was sentenced to 15 months in prison and ordered to pay $1.2M in restitution for her role in a large mortgage fraud conspiracy. According to prosecutors, Polanco and other defendants engaged in a scheme to defraud banks via fake short sales of homes, artificially decreasing their value, before another member of the conspiracy purchased the home at the artificially low value.

June 20, 2018

Healogics, a Florida-based company which runs a chain of wound care centers, has settled FCA allegations that it improperly billed for hyperbaric oxygen therapy (a modality in which the entire body is exposed to oxygen under increased atmospheric pressure, as an adjunctive therapy to treat certain chronic wounds). The company paid $22.5M to settle allegations that it billed for unnecessary or unreasonable hyperbaric oxygen therapy. The allegations were brought to the government’s attention by four whistleblowers, James Wilcox, Dr. Benjamin Van Raalte, Dr. Michael Cascio, and John Murtangh. The whistleblowers will receive a $4.28M reward. Separately, Healogics also paid $398K to settle another FCA case alleging that it improperly applied Modifier 25, which signifies that a separate evaluation and management service was performed on the same day as another procedure, to claims that were sent to Medicare, Medicaid, and TRICARE. The allegations were brought to light by a whistleblower, who will receive a $91K reward. ;

June 19, 2018

Luis Diaz and Luis J. Diaz, owners of a Miami-based export business, were convicted of operating an unlicensed money transmitting business and running a large, international money laundering scheme. The Diaz brothers avoided the anti-money laundering safeguards required of licensed institutions and moved over $100M through US banks and other financial institutions. Both brothers were sentenced to two years in prison.

June 18, 2018

Ronald Grusd, a Beverly Hills radiologist, was sentenced to 10 years in prison for his role in a massive worker’s comp scheme. The scheme involved the payment of over $100k in kickbacks in exchange for referrals or workers’ comp patients for a variety of services, including MRIs and ultrasound scans. Dr. Grusd billed over $22M in services based on these referrals.

June 15, 2018

Adam Hand, a California-based former stock broker, was sentenced to 30 months in prison relating to charges of conspiracy to commit securities fraud. Hand and his brother participated in a “pump and dump” scheme that involved manipulating the price of Crown Marketing, a penny stock. Due to the scheme, investors lost over $1.5M.

June 18, 2018

Gina Holley, a Tennessee-based tax preparer, pleaded guilty to filing false claims with the IRS. According to the charges, Holley improperly claimed that tax payers were entitled to fuel tax credits, resulting in a loss of over $400k of tax revenue.
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