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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.

				

			

			
						
					
			

	
		
		

			

				
				
November 13, 2019

				 The Louisiana Department of Health, which manages Louisiana’s Medicaid program, will pay $13.42 million to the federal government to resolve allegations that the state submitted false claims for federal share reimbursement of state Medicaid expenditures for long-term nursing care and hospice care.  The federal government alleged that in anticipation of a reduction in federal payments for such services, the state agency directed its healthcare contractor, Molina Medical Solutions, to pre-bill for nursing home and hospice services in order to receive funds at the existing higher rates.   				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Home Health and Hospice, 
													  Medicaid, 
													  Medical Billing Fraud, 
													  SNF, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
November 8, 2019

				 Lenox Hill Hospital and its corporate parent, Northwell Health, Inc., have agreed to pay $12.3 million for violating the Stark Law and False Claims Act in submissions to Medicare.  From 2013 to 2018, Lenox Hill paid the chair of its urology department, Dr. David Samadi, a salary and bonus that improperly took into account the value of his referrals and grossly exceeded fair market value.  In an effort to maximize revenue-generating surgeries, Samadi was repeatedly scheduled to perform overlapping surgeries, leaving patients with unsupervised medical residents in violation of both hospital and Medicare rules.  The department also billed Medicare for minor procedures performed in operating rooms with an unnecessarily full operating room staff.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Hospital Fraud, 
													  Improper Medical Personnel, 
													  Medicare, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
November 8, 2019

				 In the eleventh settlement involving the multi-state OK Compounding Pharmacy fraud scheme, podiatrist Jonathan Moore of Kentucky has agreed to pay $65,404 for the role he played in defrauding federal healthcare programs.  In exchange for illegal kickbacks disguised as “medical director fees,” Dr. Moore allegedly prescribed medically unnecessary compounded pain creams to patients, many of whom were insured by Medicare and TRICARE.  				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
November 7, 2019

				 Medical device manufacturer Life Spine Inc. has agreed to pay $5.5 million to settle fraud allegations stemming from a qui tam suit, with founder and CEO Michael Butler agreeing pay another $375,000, and VP of business development Richard Greiber agreeing to pay another $115,000.  As part of the settlement, the defendants admitted to paying kickbacks to surgeons and entities between 2012 and 2018 in exchange for their use of Life Spine’s spinal implants, devices, and equipment.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medical Devices and DME, 
													  Medicare, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
November 7, 2019

				 Compound drug ingredient supplier Fagron Holding USA LLC has agreed to pay over $22 million to resolve two qui tam suits involving three of Fagron’s wholly-owned subsidiaries.  According to whistleblowers, Freedom Pharmaceuticals Inc. grossly inflated the price of active pharmaceutical ingredients used in compound prescriptions, causing pharmacy customers to submit false claims to TRICARE.  Other allegations involved subsidiaries Pharmacy Services Inc. and B&B Pharmaceuticals Inc., which were accused of submitting false claims to federal healthcare programs, manipulating prescription drug pricing, paying kickbacks to physicians, and illegally waiving patient copays.  				 					 

						
Tagged in:
													  Compounding Pharmacy Fraud, 
													  Drug and DME Pricing, 
													  FCA Federal, 
													  Other Government Health Programs, 
													  Pharma Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
November 7, 2019

				 Tower Research Capital, LLC, a proprietary trading firm, has been ordered to pay a record $67.4 million for engaging in a manipulative and deceptive spoofing scheme from 2012 to 2013.  The Commission found that when Tower traders had genuine orders on one side of the market, they would also place orders on the other side that they intended to cancel before execution, intending to create a false impression of supply and demand to induce other market participants to trade against their genuine orders. The judgment for over $32.6 million in restitution, $10.5 million in disgorgement, and $24.4 million in civil monetary penalty is reportedly the largest ever ordered in a spoofing case. Tower also entered into a deferred prosecution agreement in a settlement with DOJ, crediting their monetary settlement with the CFTC and imposing compliance obligations. ; 				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Fraud in CFTC-Regulated Markets, 
													  Market Manipulation and Trading Violations, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
November 6, 2019

				 Winston Shrout, who became a fugitive after being sentenced to 10 years in prison in 2017, has been captured and returned to custody.  Shrout led seminars promoting the use of fraudulent financial instruments as a means to avoid taxes, and sold materials for the preparation of such fraudulent instruments.  In addition, Shrout failed to file tax returns from 2009 through 2014.   				 					 

						
Tagged in:
													  Abusive Tax Shelters, 
													  Criminal Proceedings, 
													  Tax Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
November 5, 2019

				 A home health agency that allegedly defrauded Medicare and Louisiana’s Medicaid program has agreed to pay $2.5 million to settle claims arising from a qui tam suit.  Defendants Health Care Options, Inc., Health Care Options of Lafayette, Inc., Home Care Options Houston, Inc., and Howard Austin, II allegedly submitted reimbursement claims involving non-face-to-face encounters, as required by program rules.  				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Home Health and Hospice, 
													  Medicaid, 
													  Medicare, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
November 1, 2019

				 A New York-based painting contractor has agreed to pay $3 million to settle a suit alleging it misrepresented compliance with Disadvantaged Business Enterprise (DBE) rules in connection with two federally funded construction projects.  The False Claims Act violations involved Ahern Painting Contractors Co., which was contractually required to hire DBE subcontractors to perform renovation work on the Brooklyn Bridge and Queens Plaza.  However, Ahern hired a non-DBE, Spectrum Painting Corp., and repeatedly submitted false statements to the government that represented the work was done by a real DBE, Tower Maintenance Corp.  				 					 

						
Tagged in:
													  FCA Federal, 
													  Government Programs Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 31, 2019

				 In the largest healthcare fraud case ever to come out of Mississippi, pharmacy owner Thomas Spell has been sentenced to 10 years in prison and ordered to pay over $243 million in restitution for knowingly defrauding TRICARE.  Between 2014 and 2016, Spell and his co-conspirators had deviously marketed compounded medications based on their rate of reimbursement from TRICARE, paid illegal kickbacks to marketers in order to obtain prescriptions from TRICARE beneficiaries, and improperly waived mandatory copayments for TRICARE beneficiaries.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Compounding Pharmacy Fraud, 
													  Healthcare Fraud, 
													  Other Government Health Programs, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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