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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.

				

			

			
						
					
			

	
		
		

			

				
				
January 16, 2020

				 Udaya Shetty, a psychiatrist in Virginia, was sentenced to over two years in prison and has agreed to pay over $1 million to the United States and the Commonwealth of Virginia to resolve allegations of submitting false claims to Medicare, Medicaid, and TRICARE.  Shetty was accused of billing for services that average about 40-60 minutes long, despite quadruple booking patients and only seeing them for about 5-10 minutes each.  The scheme began at his own practice, Behavioral & Neuropsychiatric Group, in 2013, and continued at a new practice, Quietly Radiant Psychiatric Services, in 2017.  As a result of his actions, government health programs were defrauded of more than $450,000.  				 					 

						
Tagged in:
													  FCA Federal, 
													  FCA State, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medicare, 
													  Other Government Health Programs, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 16, 2020

				 A former pharmaceutical sales representative in Texas has been sentenced to 2.5 years in prison and ordered to pay $1,746,222 in restitution for participating in a healthcare bribery scheme from 2013 to 2014.  In return for receiving commissions from pharmacies and paying them to medical providers, Holly Blakely had submitted fraudulent prescriptions to two different compounding pharmacies on behalf of unsuspecting individuals, causing approximately $8.8 million in losses to private and government healthcare providers.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 15, 2020

				 ResMed Corp. has agreed to pay $37.5 million to resolve five whistleblower-brought lawsuits alleging that the durable medical equipment (DME) manufacturer paid illegal kickbacks to suppliers, sleep labs, and other health providers, in violation of the Anti-Kickback Statute and False Claims Act.  $6.2 million of the settlement will be split amongst the whistleblowers, who had revealed that ResMed improperly provided or helped provide free or below cost call center services, patient outreach services, medical equipment and installation, and interest-free loans, in exchange for business.  ; ; ; ; ; 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medical Devices and DME, 
													  Medicare, 
													  Other Government Health Programs, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 15, 2020

				 TMJ & Orofacial Pain Treatment Centers of Wisconsin has agreed to pay $1 million to settle a qui tam suit alleging submissions of false claims to Medicare and TRICARE.  According to the anonymous whistleblower, who will receive an undisclosed share of the settlement, TMJ billed the government health programs for prosthetic devices as if they had been fabricated by in-house surgeons, when in fact they had been fabricated by an outside laboratory.  				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medical Billing Fraud, 
													  Medical Devices and DME, 
													  Medicare, 
													  Other Government Health Programs, 
													  Provider Fraud, 
													  Upcoding, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			


 			




	
		
		

			

				
				
January 10, 2020

				 Punch It Performance and Tuning, together with related entities and individuals, has agreed to stop manufacturing and selling aftermarket emissions defeat devices, and pay a civil penalty of $850,000.  The products sold by Punch It included hardware and software designed to hack into and reprogram a motor vehicle’s electronic control module to alter engine performance and enable the removal of filters, catalysts and other critical emissions controls that reduce air pollution. Such products are illegal under the Clean Air Act.  				 					 

						
Tagged in:
													  Environmental Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 10, 2020

				 The owner of two Philadelphia-based testing laboratories has pleaded guilty and agreed to pay more than $77 million in restitution for participating in an illegal kickback scheme.  At his plea hearing, Ravitej Reddy admitted that his laboratories, Personalized Genetics, LLC and Med Health Services Management, LP, participated in a fraudulent scheme that took advantage of the labs' location in a high reimbursement area for Medicare cancer and pharmacogenetic testing the labs actually sent for testing to a laboratory that was located outside of the lucrative coverage area, because the labs lacked equipment to perform the tests themselves.  To secure the lab orders, Reddy admitted paying kickbacks to co-conspirators, including marketers that solicited specimens from Medicare beneficiaries, and a telemedicine practice that improperly authorized the tests without regard to medical necessity.  In addition to the restitution order, Reddy faces a maximum of 25 years in prison at his sentencing in February.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Healthcare Fraud, 
													  Laboratory and IDTF, 
													  Lack of Medical Necessity, 
													  Medicare, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 9, 2020

				 After being charged with defrauding brokerage customers in May 2018 and pleading guilty in December 2018, a former registered investment advisor, Steven Pagartanis, has been sentenced to over 14 years in prison and ordered to pay $6.5 million for orchestrating the 18-year, $13 million fraud.  Pagartanis had targeted elderly women and promised an 8% return on investments.  However, he secretly laundered their investments and used the money on personal expenses, causing investors to lose over $9 million in total.   				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 7, 2020

				 Behavioral Consulting of Tampa Bay (BCOTB) has agreed to pay $675,000 to settle claims alleging the autism service provider submitted false or fraudulent claims to TRICARE.  Following an audit by TRICARE's managed care support contractor, the United States launched an investigation into BCOTB's claims that revealed it had misrepresented the services that were provided, misrepresented the identity of service providers, requested payment on more units of time than reflected by records, and requested payment on services that were not substantiated by records.  				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Misrepresentations, 
													  Other Government Health Programs, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 7, 2020

				 After self-disclosing to the government about grant accounting errors in 2011, the University of North Carolina at Chapel Hill (UNC) has agreed to pay back $4.5 million in excess funds received from the National Institutes of Health (NIH).  The errors had been in effect between two different periods, from 2007 to 2011 and from 2014 to 2017, and had caused the University to inadvertently charge salary costs to grants after the grant terms had ended.  				 					 

						
Tagged in:
													  Accounting Fraud, 
													  Grant and Research Fraud, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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