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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.

				

			

			
						
					
			

	
		
		

			

				
				
March 18, 2021

				 A Michigan-based cardiologist, Dinesh Shah, and his practice, Michigan Physicians Group, P.C. (MPG), have agreed to pay $2 million to resolve allegations of defrauding Medicare, Medicaid, and TRICARE by submitting claims for medically unnecessary diagnostic testing, in violation of the False Claims Act.  In separate qui tam suits filed by former employees Arlene Klinke and Khrystyna Mala, the whistleblowers alleged that between 2006 and 2017, Shah and MPG billed government healthcare programs for Ankle Brachial Index tests, Toe Brachial Index tests, and Nuclear Stress Tests that were ordered and provided without regard to necessity.  				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Medicare, 
													  Other Government Health Programs, 
													  Provider Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
March 16, 2021

				 Jack Lee Stapleton and Jack Hunter Stapleton, the former owners of a Florida-based telemarketing company known as CV McDowell LLC or J&J Tel Marketing LLC (the Stapleton Entities), have agreed to pay at least $4 million to resolve a qui tam case by a former employee alleging violations of the False Claims Act.  According to whistleblower Dwayne Thornton, the Stapletons solicited prospective patients through telemarketing calls, convinced them to accept compounded drugs regardless of need, and then procured prescriptions and sent them to compounding pharmacies that agreed to pay the Stapletons half of all TRICARE reimbursements.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Compounding Pharmacy Fraud, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Other Government Health Programs, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
March 8, 2021

				 Vascular surgeon Feng Qin and his medical practice Qin Medical P.C. will pay $800,000 to resolve civil claims and criminal charges that Qin performed procedures on end-stage renal disease patients that were not medically reasonable and necessary, and fraudulently billed Medicare.  Qin performed vascular access procedures on patients on a routine scheduled basis, without documenting the required clinical findings.  The government’s investigation was initiated by the filing of a qui tam complaint by Mark Favors.   				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medical Billing Fraud, 
													  Medicare, 
													  Provider Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
March 5, 2021

				 A substance abuse treatment facility and two inpatient psychiatric hospitals in Ohio, along with their corporate parent, have agreed to pay $10.25 million to resolve claims under the Anti-Kickback Statute and False Claims Act.  According to DOJ, between 2013 and 2019, The Woods at Parkside, Cambridge Behavioral Hospital, and Ridgeview Behavioral Hospital—all owned by Florida-based Oglethorpe Inc.—allegedly provided improper inducements in the form of free long-distance transportation in order to entice patients to seek treatment at their facilities, and then submitted claims for services provided to those patients to Medicare.  The case was initiated by a former client advocate working at Cambridge, Darlene Baker.  ; 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Hospital Fraud, 
													  Medicare, 
													  Provider Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
March 4, 2021

				 Sohrab Sharma, a co-founder of Centra Tech, which claimed to offer products including a debit card that would allow users to make retail purchases using cryptocurrency, has been sentenced to eight years in prison following his guilty plea to charges arising from Centra’s fraudulent representations to participants in its unregistered initial coin offering of “Centra Tokens” or “CTR tokens,” which raised more than $25 million from victims.  Sharma and his co-defendants falsely claimed that Centra Tech had an experienced executive team, agreements with card issuers, and licenses to operate in 38 states when, in fact, Centra Tech had none of these things.  				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Cryptocurrency, 
													  Financial and Investment Fraud, 
													  Regulatory Violations, 
													  Securities Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
March 3, 2021

				 The CEO of a group of medical providers in Michigan and Ohio has been sentenced to 15 years in prison and ordered to pay over $51 million in restitution to Medicare, as well as forfeit over $11.5 million in cash along with multiple properties and a Detroit Pistons season ticket membership, following a trial that found him guilty for his role in an extensive fraud scheme against Medicare.  Mashiyat Rashid, the CEO of Tri-County Wellness Group, allegedly instituted a corporate policy that forced patients—many of whom were addicted to opioids and recruited from homeless shelters and soup kitchens—to submit to medically unnecessary but highly reimbursed back injections in exchange for prescriptions to medically unnecessary opioids.  To implement the policy, Rashid made a point to hire physicians who were willing to put profit over patient care, further incentivizing them by offering to split reimbursements with them.  Yet according to trial testimony, many of the patients did not want, need, or benefit from the painful back injections, which left some of them suffering from adverse conditions, including open holes in their back.  Rashid is the second defendant to be sentenced in this case; twenty-one other defendants, including two physicians, have been convicted so far. 				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medicare, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
March 2, 2021

				 North Carolina durable medical equipment provider A Perfect Fit for You, Inc. and its owner Margaret Gibson have agreed to pay a total of $24.14 million to resolve civil claims that they falsely billed Medicaid for DME that had never been ordered or delivered, including by using the personally identifying information of Medicaid recipients who had been dead for years.  In addition, to resolve criminal charges of healthcare fraud, the company will pay an additional $2 million fine and $10.1 million in restitution to the North Carolina Medicaid program.  				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medical Billing Fraud, 
													  Medical Devices and DME, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
March 2, 2021

				 Medical practice Allergy and Asthma Associates Inc., in Roanoke, Virginia, will pay $2.1 million to resolve allegations that it fraudulently billed Medicare and Medicaid for asthma treatments.  AAA treated patients with Xolair, an asthma treatment sold in single-use vials, and billed government healthcare programs for the entire vial when, in fact, they were splitting vials between different patients.  				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 26, 2021

				 United Airlines will pay a total of $49 million to resolve criminal and civil claims that its cargo division fraudulently overcharged the U.S. Postal Service under International Commercial Air (ICAIR) contracts by which United transported U.S. mail internationally.  While the contracts required United to bill the government based on the delivery of mail receptacles, as supported by departure and arrival scans of the receptacles, United submitted false data that was not based on actual scans or the movement of mail, and United employees who knew about the false data and billings took steps to conceal this information.  To resolve the criminal claims, United will pay $17.3 million in penalties and enter into a non-prosecution agreement including specific compliance and reporting requirements; to resolve civil claims under the False Claims Act, United will pay $32.2 million.  				 					 

						
Tagged in:
													  Contract Non-Compliance, 
													  Criminal Proceedings, 
													  Falsifying Invoices, 
													  FCA Federal, 
													  Government Procurement Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 25, 2021

				 Texas Center for Orthopedic and Spinal Disorders and its owner, osteopath Mark Kuper, have agreed to a judgment of $11.2 million to resolve claims arising from their fraudulent billing of government healthcare programs.  Kuper also pleaded guilty to healthcare fraud, and was sentenced to 10 years in prison.  Defendants admitted that they submitted claims for services that were never rendered, including claims for one-on-one physical therapy pursuant to an individualized plan of care, when patients were actually attending group sessions with an athletic trainer, and claims for 60-minute psychotherapy sessions when patients actually spoke with unqualified individuals for just 15-20 minutes.  In addition, Kuper permitted his wife to use his credentials to issue prescriptions for controlled substances.  The civil investigation was initiated by a qui tam complaint filed by Richard Brown, who will receive 17% of the government’s recovery.  				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medical Billing Fraud, 
													  Provider Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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