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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.

				

			

			
						
					
			

	
		
		

			

				
				
February 9, 2021

				 India-based cancer drug manufacturer Fresenius Kabi Oncology Limited (FKOL) has agreed to pay $50 million in fines and forfeiture for failing to provide certain records to FDA investigators.  In violation of the Federal Food, Drug and Cosmetic Act, which helps ensure the purity and potency of drugs sold in the United States, FKOL actively obstructed a 2013 FDA inspection of one of its plants by removing and deleting manufacturing records.  As part of the settlement, FKOL has also agreed to implement a compliance and ethics program to prevent, detect, and correct any further violations of U.S. laws.  ; 				 					 

						
Tagged in:
													  FDA Fraud, 
													  Healthcare Fraud, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 5, 2021

				 Michael Malone, the founder and former executive director of the St. Louis College Prep Charter School, was sentenced to one year in prison and ordered to pay restitution of $2.4 million, following his guilty plea to charges arising from a fraudulent scheme to obtain education funds from the Sate of Missouri by inflating the school’s average daily attendance in reports to the state and falsely claiming regular school days and hours as summer school or remedial hours.  				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Education Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 4, 2021

				 Durable medical equipment company Regency, Inc., has agreed to a $20.3 million civil settlement to resolve allegations that, together with its principal Kelly Wolfe, it violated the False Claims Act by creating dozens of front companies to submit over $400 million in false claims to government healthcare programs for the sale of DME that was not medically necessary.  Defendants were alleged to have paid unlawful kickbacks to doctors and falsely claimed that those doctors provided telehealth services to the beneficiaries, when in most cases the doctors had no interaction at all with the beneficiaries.  Wolfe also pleaded guilty to conspiracy to commit healthcare fraud and will be sentenced at a later date.  Former Regency employee Condra Albright will receive 23% of the civil recovery as a whistleblower reward.  ; 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Criminal Proceedings, 
													  FCA Federal, 
													  Lack of Medical Necessity, 
													  Medical Billing Fraud, 
													  Medical Devices and DME, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 3, 2021

				 The former CEO of Texas hospice and home health chain the Merida Group, Henry McInnis, has been sentenced to 15 years in prison following his conviction for healthcare fraud and alleged charges.  McInnis and his co-conspirator Rondey Mesquias, who was previously sentenced to 20 years in prison, submitted over $150 million in fraudulent Medicare bills between 2009 and 2018 by falsifying medical records and telling thousands of patients with long-term incurable diseases they had less than six months to live in order to enroll the patients in hospice programs for which they were otherwise unqualified.  In addition, McInnis directed Merida’s practice of paying physicians bogus “medical director” fees in exchange for those doctors falsely certifying unqualified patients for hospice and home health, as well as paying improper kickbacks to patient recruiters.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Criminal Proceedings, 
													  Healthcare Fraud, 
													  Home Health and Hospice, 
													  Lack of Medical Necessity, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 2, 2021

				 The owner of Mississippi-based Medworx Compounding and Custom Care Pharmacy, Marco Bisa Hawkins Moran, has been sentenced to ten years in prison and ordered to pay $34.3 million in fines and restitution following his guilty plea on charges related to a conspiracy to defraud TRICARE and other healthcare programs.  As part of the scheme, which resulted in the submission of $22.1 million in fraudulent claims, Moran and his co-conspirators adjusted prescription formulas to ensure the highest reimbursement, paid marketers and physicians kickbacks and bribes to obtain prescriptions for high-yield compounded medications without regard to medical necessity, and routinely waived and/or reduced the collection of copayments. 				 					 

						
Tagged in:
													  Compounding Pharmacy Fraud, 
													  Criminal Proceedings, 
													  Lack of Medical Necessity, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 1, 2021

				 Florida pain clinics Collier Anesthesia Pain, LLC and Tampa Pain Relief Center, Inc., will together pay $1.7 million to resolve claims that they violated the False Claims Act.  The clinics were alleged to have paid unlawful kickbacks to affiliated surgery centers by waiving copayments for surgical facility fees in order to induce patients to receive injection procedures. In addition, the government contended that the clinics improperly billed for evaluation and management services and psychological testing services.  				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 29, 2021

				 Medical waste processing company Stericycle Inc. will pay $600,000 to resolve allegations that it violated the Clean Air Act and state regulations at its medical waste incinerator in North Salt Lake, Utah, by operating the facility in a manner that generated nitrogen oxide (NOx) emissions that exceeded regulatory limits, as well as failing to properly conduct stack tests and comply with reporting requirements.  In addition to the civil monetary penalty, Stericycle will undertake a Supplemental Environmental Project and spend at least $2 million to purchase 20 low-emitting school buses for a local school district. 				 					 

						
Tagged in:
													  Environmental Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 28, 2021

				 Electronic health records vendor athenahealth Inc. will pay $18.25 million to resolve claims brought in two separate whistleblower actions alleging that certain Athena marketing programs provided unlawful remuneration to healthcare providers and others to induce providers to purchase Athena’s EHR systems.  Remuneration to current and prospective customers included all-expenses paid trips to sporting, entertainment, and recreational events, as well as cash payments to customers who referred others to Athena.  In addition, Athena paid other EHR vendors who referred clients to Athena when they were discontinuing their own EHR products and services. The kickbacks allegedly improperly generated sales for Athena while causing healthcare providers to submit false claims to the federal government for incentive payments related to the adoption and “meaningful use” of Athena’s EHR technology. The whistleblowers, Geordie Sanborn, Cheryl Lovell, and William McKusick, will receive a share of the total settlement that remains to be determined.  ; 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Electronic Health Records, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Provider Fraud, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 27, 2021

				 One of the largest marketing companies in the world, Epsilon Data Management LLC, has agreed to pay $150 million to settle claims that its Direct to Consumer (DTC) Unit knowingly sold the data of more than 30 million consumers—which the company had identified as most likely to respond to marketing solicitations—to clients it knew were engaged in fraud schemes against the elderly and other vulnerable individuals.  In addition to the monetary settlement, $127.5 million of which will be set aside for victim restitution, Epsilon has entered into a deferred prosecution agreement with the government, agreed to implement significant compliance measures to safeguard consumer data, and agreed to maintain a procedure for consumers to request that their data not be sold.  				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Cybersecurity and Data Breaches, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 22, 2021

				 The estate of Dr. Patrick T. Hunter has agreed to pay more than $1.7 million to resolve allegations that the urologist, who passed away in 2019, submitted false claims to Medicare and TRICARE for medically unnecessary procedures and received improper payments for them from the Orlando Center for Outpatient Surgery.  Between 2010 and 2016, Dr. Hunter allegedly performed the lithotripsy procedures, which break up kidney stones, on patients who either did not have kidney stones or were not medically indicated for them.  For initiating the successful qui tam suit, whistleblower Scott Thompson will receive a relator’s share of $385,000.  				 					 

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

					
	
							
	
		
		
	


 			


											

						

								

									
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