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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.

				

			

			
						
					
			

	
		
		

			

				
				
May 25, 2021

				 Upper Allegheny Health System (UAHS), which operates dental clinics in New York and Pennsylvania, has agreed to pay $2.7 million to resolve whistleblower-brought allegations of submitting false claims to Medicaid in violation of the federal and New York False Claims Acts.  Between 2010 and 2015, UAHS had billed Medicaid for dental services performed using improperly sterilized handpieces, which are considered semi-critical devices and need to be properly heat sterilized between patients.  ; ; 				 					 

						
Tagged in:
													  FCA Federal, 
													  FCA State, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medical Devices and DME, 
													  Provider Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 21, 2021

				 SavaSeniorCare LLC and related entities (“Sava”) will pay $11.2 million, plus potentially more pursuant to an “ability-to-pay” settlement, to resolve allegations that Sava violated the False Claims Act by causing its skilled nursing facilities to bill Medicare for rehabilitation therapy services that were not reasonable, necessary, or skilled, and that Sava billed the Medicare and Medicaid programs for grossly substandard (i.e., “worthless”) skilled nursing services.  The settlement stems from four separate qui tam complaints filed by whistleblowers Rita Hayward, Trammel Kukoyi, Terrence Scott, James Thornton, and Barbara Roberts, who will share an undisclosed portion of the government’s recovery.  In 2015, the United States intervened in the litigation and filed a consolidated False Claims Act complaint, alleging inter alia that Sava had exerted significant pressure on its skilled nursing facilities to meet unrealistic corporate targets for the highest Medicare reimbursement rates without regard to patients’ actual clinical needs, and improperly delayed the discharge of patients from its facilities in order to increase billings.  Sava will enter into a five-year Corporate Integrity Agreement as part of the settlement.  				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Improper Medical Personnel, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Medicare, 
													  SNF, 
													  Upcoding, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 19, 2021

				 In one of the first settlements to resolve allegations under both the False Claims Act and the Open Payments Program (formerly the “Sunshine Act”), French medical device manufacturer Medicrea International and its American affiliate, Medicrea USA Inc., have agreed to pay $2 million to resolve whistleblower Dory Frain’s allegations that the companies violated the Anti-Kickback Statute while entertaining U.S.-based physicians at a conference in France in 2013.  The settlement also resolves allegations that the companies violated the Open Payments Program by failing to report those expenses to the Centers for Medicare & Medicaid Services.  ; ; 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  FCA State, 
													  Healthcare Fraud, 
													  Medical Devices and DME, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 18, 2021

				 Javaid Perwaiz, an ob/gyn who practiced in Hampton Roads, Virginia, was sentenced to 59 years in prison after a jury convicted him of charges related to his performance of hysterectomies, sterilizations, and other medically unnecessary surgeries and procedures on patients without their informed consent - in many cases by falsely telling them they had cancer or needed the procedure to avoid cancer.  In addition, Perwaiz induced labor in patients early so that he could bill for the deliveries, sometimes falsifying records to support the induction.  				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Lack of Medical Necessity, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 14, 2021

				 Dusko Bruer, who owned and operated an agricultural machinery company, was sentenced to two years in prison and ordered to pay $2.8 million in restitution following his conviction on tax evasion charges.  Between 2003 and 2009, Bruer's company did not file or pay either corporate or employment taxes.  Bruer was not paid a salary; instead, he used funds from corporate bank accounts for personal expenses.  Bruer also failed to report foreign bank accounts that he owned and controlled, and to which he transferred millions of dollars between at last 2006 and 2015.   				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Employment Tax Fraud, 
													  Tax Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 14, 2021

				 Texas dentists Gunjan Dhir and Gaurav Puri and their affiliated management companies and practice groups will pay $3.1 million to resolve allegations that they fraudulently charged the Texas Medicaid program for pediatric dental services.  The investigation was initiated by the filing of a qui tam complaint by whistleblowers Sandy Puga, Nelda Torres-Brown, and Sonia Cardoso, who were former employees of defendants and will receive an undisclosed share the settlement.  Defendants allegedly billed for services that were not actually provided and/or misreported the provider of services by using erroneous Medicaid provider numbers.  				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 14, 2021

				 Swiss insurance company Swiss Life Holding AG and related entities will pay $77 million and enter into a deferred prosecution agreement admitting that they conspired with U.S. taxpayers to  conceal more than $1.452 billion in assets and income in offshore insurance policies and related policy investment accounts.  From 2005 to 2014, Swiss Life maintained approximately 1,608 Private Placement Life Insurance policies known as “insurance wrappers,” with associated policy investment accounts with Swiss Life entities identified as the owner, allowing U.S. taxpayers to hide undeclared assets and income and evade taxes.  Beginning in 2008, Swiss Life specifically marketed such policies to taxpayers withdrawing assets from UBS and other Swiss banks in response to offshore tax enforcement efforts aimed at those bank.  ; 				 					 

						
Tagged in:
													  Abusive Tax Shelters, 
													  Tax Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 13, 2021

				 Financial services company State Street Corporation will pay a $115 million criminal penalty and enter into a deferred prosecution agreement following its voluntary disclosure to authorities that, over the course of 17 years, the bank defrauded its clients out of $290 million.  State Street  admitted that it secretly marked up “out-of-pocket” (OOP) expenses charged to clients, despite telling clients that OOP expenses were passed through without markups. State Street executives took steps to conceal the mark-ups from clients, including by misleading clients when they inquired about what they were being charged for OOP expenses. As part of the settlement, defendant agreed to cooperate with ongoing investigations, to enhance its compliance program, and to retain an independent corporate compliance monitor for a period of two years. 				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 12, 2021

				 Technology company MobileActive will pay $500,000, and its principal Katrin Verclas will serve two years in prison in civil and criminal resolutions arising from the defendants' scheme to defraud the U.S. State Department's Bureau of Democracy, Human Rights, and Labor ("DRL").  In 2010, MobileActive applied for and was awarded a $1.4 million DRL grant to develop and promote a "mobile security toolkit" for human rights organizations and activists to use in assessing and mitigating risks associated with mobile communications. After claiming $1.2 million in grant funds, Verclas failed to respond to requests for information from the State Department; she has admitted that she failed to comply with grant requirements, and directed the funds to her personal use while concealing the nature of the transactions from MobileActive's bank.  				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Grant and Research Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 10, 2021

				 The University of Miami, which operates multiple hospitals and other healthcare facilities, will pay $22 million to resolve claims arising from allegedly fraudulent billing submitted to federal healthcare programs for laboratory services.  The university was alleged to have billed certain laboratory tests as having been provided at hospital facilities instead of at physician offices, without satisfying the requirements for that more costly hospital facility billing, including notice requirements.  In addition, the university was alleged to have performed and billed for a pre-set panel of tests for all kidney transplant patients, although not all included tests were medically necessary.  Finally, the university and Jackson Memorial Hospital, which jointly operated the kidney transplant program, were alleged to have violated related party restrictions by billing for pre-transplant laboratory tests ordered by JMH from the university, and JMH will pay an additional $1.1 million to settle these allegations.  The settlement resolves claims made in three separate qui tam lawsuits; the whistleblower's share has not yet been determined.  ; 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Hospital Fraud, 
													  Laboratory and IDTF, 
													  Lack of Medical Necessity, 
													  Medical Billing Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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