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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 听rise to a claim for a whistleblower reward, please contact us to speak with one of our experienced whistleblower attorneys.

				

			

			
						
					
			

	
		
		

			

				
				
September 3, 2020

				 Two affiliates of Independence Blue Cross, Keystone Health Plan East, Inc. and QCC Insurance Company, Inc., which offer Part C Medicare Advantage plans, agreed to pay $2.25 million to resolve allegations that they overstated their costs when they submitted bids to CMS for contract years 2009 and 2010.听 As a result, CMS reimbursed them at at an inflated rate.听 The matter was initiated by the filing a qui tam complaint under the False Claims act by Eric Johnson, who will receive $500,000 from the recovery.听 				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Managed Care, 
													  Medicare, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 31, 2020

				 CDM Smith Inc. and CDM Federal Programs Corporation paid $5.6 million to resolve charges that they violated the False Claims Act and Truth in Negotiations Act by submitting inaccurate cost and labor hour estimates and related certifications in connection with task orders on a federal contract to supply architect-engineering services to Navy bases.听 The case was initiated by an unnamed whistleblower, who will receive a share of the recovery.听 				 					 

						
Tagged in:
													  FCA Federal, 
													  Government Procurement Fraud, 
													  Pricing Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 31, 2020

				 Brooklyn, New York resident Aleksander Pikus was sentenced to 13 years in prison and ordered to pay $39.4 million in restitution and forfeit $2.6 million following his conviction at trial for charges related to a kickback and tax avoidance scheme involving a number of medical clinics in Brooklyn and Queens.听 Pikus referred patients to the clinics, receiving kickbacks in exchange, which he used to pay patient recruiters and patients themselves.听 Pikus used shell companies and fake invoices to conceal his scheme and failed to report cash income to the IRS.听 ; 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Criminal Proceedings, 
													  Healthcare Fraud, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 28, 2020

				 Herbalife Nutrition Ltd. will pay over $123 million to resolve claims that the US-based company violated the Foreign Corrupt 91porn Act by paying bribes to Chinese officials and other state-owned entities in order to secure required direct selling licenses, improperly influence Chinese investigations into Herbalife's business, and improperly influence Chinese state-owned and state-controlled media for the purpose of removing negative media reports about Herbalife. Herbalife admitted that over the course of ten years it falsified its books and records in order to provide corrupt payments and benefits to Chinese government officials.听 To resolve criminal charges, Herbalife will enter into a deferred prosecution agreement and pay a $55 million criminal penalty; to resolve civil charges by the SEC, Herbalife will pay disgorgement and interest totaling approximately $67 million.听 ; ; 				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  FCPA, 
													  Financial and Investment Fraud, 
													  Securities Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 26, 2020

				 LA-based clothing company Ambiance Apparel and its owner Sang Bum 鈥淓d鈥� Noh have pleaded guilty to customs violations and tax offenses, agreeing to pay a total of $118 million, which includes $36 million in previously-seized cash.听 Defendants evaded import tariffs by colluding with Asian manufacturers for the submission of invoices to CBP that fraudulently understated the value of imported clothing. The fraudulent invoices indicated payment terms by letter of credit; a second invoice for the balance of the actual price was paid by defendants by wire transfer. In less than five years, Ambiance undervalued imports by about $82.6 million and failed to pay more than $17.1 million in tariffs. In addition, defendants failed to properly report cash transactions and maintained a second set of books for cash transactions, evading nearly $17 million in taxes.听 The company will be placed on probation for five years and will be ordered to undertake specific compliance procedures.听 				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Customs Fraud, 
													  Financial and Investment Fraud, 
													  Tax Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 24, 2020

				 Following a whistleblower suit by a former sales representative,听DUSA Pharmaceuticals (DUSA), a Massachusetts-based subsidiary of Sun Pharmaceuticals Industries Inc. (Sun Pharma), has agreed to pay听$20.75 million听to resolve allegations of defrauding Medicare and the Federal Employee Health Benefit Pr颅颅颅ogram.听 According to relator Aaron Chung, senior management at DUSA and Sun Pharma allegedly encouraged doctors, via paid speaker programs and discussions, to use shorter incubation periods of 1-3 hours for Levulan Kerastick, a topical prescription medication for treating actinic keratosis (AK) of the face and scalp that had FDA-approved instructions for 14-18 hour incubation periods.听 As expected, the significantly reduced incubation periods resulted in significantly reduced AK clearance rates, yet DUSA failed to inform doctors of the lower rates and even actively misinformed them that AK clearance rates were the same regardless of incubation period.听 For exposing the fraudulent conduct, Chung will receive approximately $3.5 million of the settlement proceeds.听听;听				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicare, 
													  Other Government Health Programs, 
													  Pharma Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 21, 2020

				 Cardiologist Ghanshyam Bhambhani of Queens, New York, paid $2 million to settle allegations that he paid kickbacks to fellow physicians for patient referrals.听 Specifically, defendant was alleged to have paid other doctors compensation disguised as rent for patient referrals in violation of the Anti-Kickback Statute and the False Claims Act, and falsified records to justify cardiac procedures. 听The action was initiated by the filing of a whistleblower complaint. 听				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 21, 2020

				 Fire protection services contractor Fiore Industries Inc. will pay $1.2 million to resolve claims that it violated the False Claims Act by overstating its workers鈥� compensation rates in submitting claims for work it preformed at NASA鈥檚 Ames Field Center, thereby overcharging the government.听 Fiore鈥檚 stated workers compensation rates did not account for discounts it knew it would receive.听 				 					 

						
Tagged in:
													  Falsifying Invoices, 
													  FCA Federal, 
													  Government Procurement Fraud, 
													  Pricing Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 21, 2020

				 A Georgia-based chiropractor and her medical practice have been ordered to pay more than听$5 million听for violating the False Claims Act.听 The government alleged that听Dr. Jennifer Heller, D.C.听caused Medicare to pay $1.4 million more than it would have had it known that hundreds of Heller鈥檚 charges for a surgical neurostimulator procedure were in actuality for acupuncture devices, which are not covered by Medicare, and which do not require surgery.听 To resolve the charges,听Heller Family Medicine, LLC听will have to pay $4.3 million, while Heller herself will have to pay $700,000.听听				 					 

						
Tagged in:
													  Chiropractic, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medical Billing Fraud, 
													  Medical Devices and DME, 
													  Medicare, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
August 20, 2020

				 Defense contractor听Islands Mechanical Contractor, Inc. (IMC)听has paid the United States听$1.1 million听to settle claims of improperly submitting equitable adjustment claims relating to a delayed facility construction project at Guantanamo Bay.听 An investigation by the Defense Contract Audit Agency had found that IMC鈥檚 claims for equipment and worker standby costs were based on misrepresented information, as both the equipment and workers listed on the claims had been reallocated to other projects and were no longer on standby.听听				 					 

						
Tagged in:
													  Defense Contract Fraud, 
													  FCA Federal, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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