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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.

				

			

			
						
					
			

	
		
		

			

				
				
January 31, 2018

				 Brooklyn-based home health care company Home Family Care, Inc. and its co-owner and president agreed to pay roughly $6.4 million to settle claims they violated the False Claims Act by billing Medicaid for home health care services the company did not provide to Medicaid recipients. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. 				 					 

						
Tagged in:
													  FCA Federal, 
													  Home Health and Hospice, 
													  Medicaid, 
													  Medical Billing Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 30, 2018

				 Tampa’s largest ambulance providers AmeriCare Ambulance Service, Inc. and its sister company AmeriCare ALS, Inc. agreed to pay roughly $5.5 million to settle claims they violated the False Claims Act by billing Medicare for medically unnecessary ambulance transportation services. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former AmeriCare employee Ernest Sharp. He will receive a whistleblower award of roughly $1.15 million from the proceeds of the government’s recovery. 				 					 

						
Tagged in:
													  Ambulance, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 29, 2018

				 A judgment of roughly $16 million was entered against Orthopaedic and Neuro Imaging LLC for violating the False Claims Act by submitting claims for contrast dye MRI scans not properly supervised by a physician. 				 					 

						
Tagged in:
													  FCA Federal, 
													  Improper Medical Personnel, 
													  Medical Billing Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 25, 2018

				 SunCoke Energy Inc., its subsidiary Indiana Harbor Coke Company, and Cokenergy have agreed to spend $250,000 in abatement costs and pay a $5 million civil penalty to resolve alleged Clean Air Act violations relating to excess emissions of coke oven gases from their coke plant in East Chicago, Indiana. 				 					 

						
Tagged in:
													  Environmental Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 25, 2018

				 Primex Clinical Laboratories, LLC agreed to pay $3.5 million to settle claims it violated the False Claims Act and Anti-Kickbacks Statue by paying kickbacks in exchange for laboratory referrals for patient pharmacogenetic testing. The allegations originated by a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former sales reps Don Pyburn and David Choate. They will receive a whistleblower award of $754,000 from the proceeds of the government’s recovery. 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Laboratory and IDTF, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 24, 2018

				 Tennessee chiropractor Matthew Anderson agreed to pay $1.45 million to resolve allegations he violated the False Claims Act. Specifically, the government alleged that Anderson and his management company, PMC LLC, caused pharmacies to submit requests for Medicare and TennCare payments for pain killers dispensed based upon prescriptions written at the Cookeville Center for Pain Management, one of the pain clinics Anderson managed, which had no legitimate medical purpose. The government further alleged that Anderson caused four pain clinics he managed to bill Medicare for upcoded claims for office visits that were not reimbursable at the levels sought. The allegations originated in a whistleblower lawsuit filed by a former office manager for the Cookeville Center for Pain Management under the qui tam provisions of the False Claims Act. The whistleblower will receive a whistleblower award of $246,500 from the proceeds of the government's recovery. 				 					 

						
Tagged in:
													  Chiropractic, 
													  FCA Federal, 
													  Lack of Medical Necessity, 
													  Provider Fraud, 
													  Upcoding, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 23, 2018

				 Drs. Aytac Apaydin and Stephen Worsham, urologists based in Northern California who own Salinas Valley Urology Associates and formerly owned Advance Radiation Oncology Center, will pay roughly $1 million to settle claims they violated the False Claims Act by submitting claims to Medicare for image guided radiation therapy (IGRT) that was referred and billed in violation of the physician self-referral law (the “Stark Law”) and the Anti-Kickback Statute. 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 23, 2018

				 California medical device company DJO Global Inc. agreed to pay $7.62 million to resolve allegations that its Minnesota subsidiary Empi Inc. submitted false claims to TRICARE for excessive, unnecessary transcutaneous electrical nerve stimulation electrodes that TRICARE beneficiaries did not need or use. TENS is a therapy that uses low-voltage electrical current for pain relief. 				 					 

						
Tagged in:
													  Lack of Medical Necessity, 
													  Medical Devices and DME, 
													  Other Government Health Programs, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 8, 2018

				 Two individuals were found guilty yesterday for their roles in a $10 million telemarketing scheme that defrauded primarily elderly victims in the United States from call centers in Costa Rica. According to the evidence presented at trial, both Smith and Griffin worked in a call center in Costa Rica in which conspirators, who posed as representatives of the Securities and Exchange Commission and the Federal Trade Commission (FTC), contacted victims in the United States to tell them that that they had won a substantial “sweepstakes” prize. After convincing victims, many of whom were elderly, that they stood to receive a significant financial reward, the conspirators told victims that they needed to make a series of up-front payments before collecting their supposed prize, purportedly for items like insurance fees, taxes and customs duties. Conspirators used a variety of means to conceal their true identities, such as Voice over Internet Protocols, which made it appear that they were calling from Washington, D.C., and other places in the United States. According to trial testimony, one elderly victim who indicated she was going to stop paying was warned by a conspirator that they knew where she and her family lived. 				 			
	
		
		
	


 			




	
		
		

			

				
				
January 19, 2018

				 San Diego-based health care system Scripps Health agreed to pay $1.5 million to resolve allegations it violated the False Claims Act by charging federal health care programs for physical therapy services that were rendered by therapists who did not have billing privileges for these programs and were not supervised by an authorized provider. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Scripps employee Suzanne Forrest. She will receive a whistleblower award of $225,000 from the proceeds of the government's recovery. 				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Improper Medical Personnel, 
													  Medical Billing Fraud, 
													  Provider Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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