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

				

			

			
						
					
			

	
		
		

			

				
				
July 23, 2020

				 Two pharmacists who were co-owners of Advantage Pharmacy in Mississippi have been sentenced to over 12 years in prison each and ordered to pay between $9 million and $29 million in civil monetary judgment, and between $185 million and $189 million in restitution for committing healthcare fraud.听 According to the press release, Glenn Doyle Beach and Hope Thomley marketed, dispensed, and distributed compounded medications without regard to medical necessity, causing various health benefit programs, including TRICARE, to pay over $200 million in reimbursements.听 Thomley鈥檚 husband, Randy Thomley, has been sentenced to 8 years in prison and ordered to pay judgment and restitution of $3.6 million each for his role in helping to recruit TRICARE beneficiaries.听 				 					 

						
Tagged in:
													  Compounding Pharmacy Fraud, 
													  Criminal Proceedings, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Other Government Health Programs, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 23, 2020

				 Progenity, Inc., f/k/a Ascendant MDx, Inc., has agreed to pay a total of $49 million to resolve allegations that the California-based clinical laboratory submitted false claims to Medicaid, the VA, TRICARE, and the Federal Employees Health Benefits Program (FEHBP) through different fraudulent schemes.听 First, from 2012 to 2016, Progenity allegedly billed the programs for non-reimbursable prenatal tests using a reimbursable billing code.听 Second, in claims originally brought by a whistleblower under the False Claims Act, the company was alleged to violate the Anti-Kickback Statue by providing improper incentives to physicians鈥攊ncluding paying above fair market value for blood specimen 鈥渄raw fees鈥�, providing tens of thousands of dollars in free food and alcohol, and routinely reducing or waiving co-insurance or deductibles鈥攊n order to induce physicians to order their tests.听 Approximately $35.9 million of the settlement proceeds will go toward resolving federal claims, with the remaining $13.1 million paid to different states.听 ; ; 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Laboratory and IDTF, 
													  Medicaid, 
													  Medical Billing Fraud, 
													  Other Government Health Programs, 
													  Upcoding, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 22, 2020

				 Auto parts distributor CWD Holdings LLC, which does business as Centric Parts, will pay $8 million to resolve claims in False Claims Act cases brought by two whistleblowers, Steven Hughes and Jeffrey Hawk.听 The government alleged that over the course of ten years the defendant imported brake pads, falsely identifying them as unmounted brake pads, which are not subject to any tariff, when they were, in fact, mounted brake pads, which are subject to a 2.5% tariff.听 Defendant thereby knowingly evaded millions of dollars in customs duties.听 The whistleblowers will share a $1.48 million whistleblower award.听 ; 				 					 

						
Tagged in:
													  Customs Fraud, 
													  FCA Federal, 
													  Government Programs Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 21, 2020

				 The Montachusett Regional Transit Authority (MART), a quasi-public transportation authority that brokers medical transportation, will pay $300,000 to resolve allegations that it improperly caused false claims to be submitted to MassHealth, the Massachusetts state Medicaid program. MART allegedly did not have appropriate procedures in place to verify that its transportation subcontractors had actually provided rides as they claimed, and MART billed MassHealth for thousands of rides that were not, in fact, provided. ; 				 					 

						
Tagged in:
													  Ambulance, 
													  FCA State, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medical Billing Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 20, 2020

				 Drug testing laboratory Sterling Healthcare Opco, LLC, doing business as Cordant Health Solutions will pay $12 million to resolve allegations in a False Claims Act case brought by a whistleblower that it paid unlawful kickbacks to Northwest Physicians Laboratories, LLC and Genesis Marketing Group in exchange for referrals of urine drug tests paid for by federal healthcare programs and performed at Cordant labs in Tacoma (Regional Toxicology Services LLC d/b/a Sterling Reference Laboratory) and Denver (Rocky Mountain Tox LLC d/b/a Forensic Laboratories).听 The whistleblower will receive 20% of the settlement, or approximately $2.4 million.听 				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 20, 2020

				 Defense contractor iNovex Information Systems, Inc., will pay $1 million to resolve claims that it violated the FCA by overcharging the National Security Agency.听 Defendant allegedly invoiced the NSA for services it claimed were provided by personnel who met contractually specified training and qualification requirements when, in fact, it knew that those employees did not meet all of the specialized qualifications. 聽				 					 

						
Tagged in:
													  Defense Contract Fraud, 
													  Falsifying Invoices, 
													  FCA Federal, 
													  Government Procurement Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 13, 2020

				 Longwood Management Company and 27 affiliated skilled nursing facilities have agreed to pay $16.7 million to resolve allegations raised by whistleblowers Judy Boyce, Benjamin Monsod, and Keith Pennetti in two separate qui tam filings, that six Longwood facilities knowingly submitted false claims to Medicare. 聽Between 2018 to 2012, Longwood allegedly pressured its rehabilitation therapists to increase the amount of therapy provided to Medicare Part A patients, regardless of medical necessity, so it could claim Ultra High levels of service, which are reimbursed at the highest rate.听 As part of the settlement, Longwood will enter into a five-year Corporate Integrity Agreement, and Boyce, Monsod, and Pennetti will share a $3 million award.听 ; 				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 10, 2020

				 Universal Health Services, Inc. and UHS of Delaware, Inc. (collectively, UHS), and a Georgia-based UHS facility, Turning Point Care Center, LLC, have agreed to pay a combined $122 million to settle 18 qui tam cases pending in four jurisdictions.听 In violation of the False Claims Act, UHS allegedly billed federal healthcare programs鈥攊ncluding Medicare, Medicaid, TRICARE, the Department of Veteran Affairs, and the Federal Employee Health Benefit programs鈥攆or medically unnecessary inpatient behavioral health services, failed to provide adequate or appropriate services, and paid illegal inducements to beneficiaries of those programs.听 UHS will pay over $88 million to the federal government and nearly $29 million to individual states, for a combined penalty of $117 million, with a relator share of about $15.8 million.听 Turning Point will pay $5 million to the federal government and the State of Georgia; the whistleblower in that case will receive $861,853.64.听 ; ; ; ; ; ; 				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 10, 2020

				 A 70-year-old man in North Carolina who pleaded guilty to orchestrating a $22 million Ponzi scheme through his company, Oodles Inc., has been sentenced to 17.5 years in prison and ordered to pay $17 million in restitution.听 Hal H. Brown Jr. singlehandedly defrauded at least 60 victims鈥攊ncluding family, friends, neighbors, and fellow church members鈥攂y falsely representing that Oodles owned hundreds of millions of dollars in rights to religious-themed family shows and movies. 聽To bolster his claims, Brown developed marketing material, falsified bank statements and company agreements, and impersonated employees of media companies. 聽				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Financial and Investment Fraud, 
													  Ponzi Schemes, 
													  Securities Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 8, 2020

				 A Florida-based nonprofit that provides hospice care, palliative care, and other services to the elderly, has agreed to pay $3.2 million to resolve its liability under the False Claims Act.听 According to former Director of Hospice Care, Margaret Peters, Hope Hospice knowingly submitted false claims to Medicare, Medicaid, and TRICARE for medically unnecessary but highly reimbursed general inpatient (GIP) hospice services over a five year period.听 For blowing the whistle on the alleged fraud, Peters will receive a 19% share of the settlement.听 				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Home Health and Hospice, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Medicare, 
													  Other Government Health Programs, 
													  SNF, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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