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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.

				

			

			
						
					
			

	
		
		

			

				
				
October 30, 2019

				 Outcome Health, the trade name for ContextMedia LLC, will pay $70 million and enter into a Non-Prosecution Agreement with the U.S. to resolve allegations that the company, which sells digital advertising to be displayed in medical offices -- its primary customers are pharmaceutical companies -- fraudulently sold advertising inventory that it did not have.  To conceal this, Outcome and its executives falsified reports to customers, claiming to have delivered advertising to the contracted number of screens, and inflated patient engagement metrics.  This fraudulent activity resulted in an overstatement of Outcome's reported revenue, and Outcome used those fraudulent financial statements to obtain almost $1 billion in debt and equity financing in 2015 and 2016.   				 					 

						
Tagged in:
													  Accounting Fraud, 
													  Criminal Proceedings, 
													  Financial and Investment Fraud, 
													  Misrepresentations, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 30, 2019

				 The U.S. has reached a settlement in asset forfeiture proceedings involving assets fraudulently acquired by Low Taek Jho, also known as Jho Low, and his family, from Malaysia's international development fund, 1MDB, and held at institutions in the U.S., U.K., and Switzerland.  The settlement secures assets estimated to be worth $700 million, bringing the total recovery of assets associated with the 1MDB bribery and money laundering schemes to more than $1 billion. The assets subject to the settlement agreement include high-end real estate in Beverly Hills, New York and London; a luxury boutique hotel in Beverly Hills; and tens of millions of dollars in business investments that Low allegedly made with funds traceable to misappropriated 1MDB monies. 				 					 

						
Tagged in:
													  Financial and Investment Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 29, 2019

				 The co-defendant of a man recently sentenced for orchestrating the largest Ponzi scheme ever charged in Maryland has been sentenced to 14 years in prison and ordered to pay at least $189 million in restitution.  To facilitate the scheme to sell fake consumer debt portfolios, Jay Ledford create fake sales agreements, tax returns, and other documents to co-defendant Kevin Merrill, knowing they would be used to defraud investors.  When the two were arrested in 2018 with fellow co-conspirator Cameron Jezierski, the five-year scheme had already raked in over $396 million, with only 14% actually used to purchase consumer debt portfolios.  				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 29, 2019

				 Encompass Health Corporation (EHC), f/k/a HealthSouth Corporation, has agreed to pay $4 million to resolve of improperly billing Medicare.  According to the DOJ, between 2008 and 2012, an inpatient rehabilitation facility owned by EHC had improperly assigned low Functional Independence Measure scores on Patient Assessment Instrument forms in a bid to receive higher reimbursements from Medicare.  				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medical Billing Fraud, 
													  Medicare, 
													  Provider Fraud, 
													  Upcoding, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 29, 2019

				 A former resident of Atlanta has been sentenced to 1.5 years in prison and ordered to pay $306,179 in restitution for defrauding PERACare, the Colorado Public Employees Retirement Association’s health insurance plan.  For more than two years, Michael Bang allegedly submitted fraudulent reimbursement claims involving three Atlanta-area pharmacies to Express Scripts, which administers PERACare’s prescription benefits. Altogether, his scheme netted him over $300,000.  				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Medical Billing Fraud, 
													  Other Government Health Programs, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 28, 2019

				 Atheir Amarrah, the owner of Michigan-based Prompt Care Home Health Services Inc, has been sentenced to 5 years in prison and ordered to pay $1 million in restitution after pleading guilty to paying recruiters for referrals to Medicare beneficiaries.  In his guilty plea, Amarrah also admitted to billing Medicare for claims tainted by illegal kickbacks.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Criminal Proceedings, 
													  Healthcare Fraud, 
													  Home Health and Hospice, 
													  Medicare, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 28, 2019

				 Sanford Health, Sanford Medical Center, and Sanford Clinic have agreed to pay $20.25 million and enter into a Corporate Integrity Agreement in order to resolve alleged violations of the Anti-Kickback Statute and False Claims Act.  Despite warnings by several physicians that a top neurosurgeon was illegally profiting off his use of implantable medical devices as well as performing medically unnecessary surgeries involving the devices, Sanford did nothing to stop the offender, allowing Medicare and Medicaid to continue being defrauded.  The allegations were raised by Sanford surgeons Drs. Carl Dustin Bechtold and Bryan Wellman, who will share in a $3.4 million cut of the settlement proceeds.  ; 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Medical Devices and DME, 
													  Medicare, 
													  Provider Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 25, 2019

				 Two foundations that provide pharmaceutical co-payment assistance to patients have reached agreements to resolve claims that they failed to operate independently of their pharmaceutical company donors and violated or caused the violation of the False Claims Act and Anti-Kickback Statute by working with those companies to ensure that donations received from them would be used to cover co-payments for the donor's drugs, inducing patients to purchase the drugs.  The Chronic Disease Fund, Inc. will pay $2 million, and the Patient Access Network Foundation will pay $4 million, amounts that were arrived at based on the entities' abilities to pay.  CDF was alleged to have conspired with Novartis, Dendreon, Astellas, Onyx, and Questcor.  PANF was alleged to have conspired with Bayer, Astellas, Dendreon, and Amgen.  The foundations also entered into 3-year corporate integrity agreements.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 24, 2019

				 Engineering firm CH2M Hill will pay $6.4 million to resolve claims that it billed the U.S. Air Force for work done by personnel who did not meet educational and work experience requirements set forth in a contract between the parties for environmental consulting work.  The settlement arose following CH2M's 2017 disclosure of the overbilling and repayment of $10.5 million.  Following that payment, the Air Force contended that CH2M knew about the overpayment as early as 2011, but sought to conceal the result of its internal audit, claiming privilege.  				 					 

						
Tagged in:
													  Defense Contract Fraud, 
													  Falsifying Invoices, 
													  Government Investigation, 
													  Government Procurement Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
October 23, 2019

				 Gary Frank was sentenced to 17.5 years in prison following a guilty plea on charges related to his fraudulent business scheme.  Frank claimed to run a multi-million dollar company, Legal Coverage, Ltd., through which employers could offer legal services as part of their employee benefits package.  Based on these misrepresentations -- in fact, the company had very little revenue -- Frank obtained over $30 million in loans from financial institutions, which he used to fund his own extravagant lifestyle.  Frank was also ordered to pay restitution of $33.7 million.  				 					 

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

					
	
							
	
		
		
	


 			


											

						

								

									
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