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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.

				

			

			
						
					
			

	
		
		

			

				
				
September 26, 2019

				 The Biomedical Research Foundation of Northwest Louisiana, together with related entities and the Board of Supervisors of Louisiana State University and Agricultural and Mechanical College, which operate University Health Hospital in Shreveport, Louisiana, will pay $530,000 to resolve claims that they submitted improper claims for implantable automatic defibrillators.  To be reimbursed for the procedures, Medicare requires providers and hospitals to submit data regarding them to a qualified registry, so that the procedures can be further studied; University Health Hospital failed to make the required data submissions.  The investigation was initiated by a qui tam lawsuit filed by a whistleblower under the False Claims Act.  				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Hospital Fraud, 
													  Medical Billing Fraud, 
													  Medical Devices and DME, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 26, 2019

				 Physician Philippe R. Chain will pay $300,000 to resolve allegations that he caused the submission of false claims to Tricare while working for telemedicine company CallMD. Chain allegedly issued and approved prescriptions for compounded medications, many of which were not medically necessary, without speaking to, examining, or otherwise having a physician-patient relationship with the patients.  				 					 

						
Tagged in:
													  Compounding Pharmacy Fraud, 
													  FCA Federal, 
													  Lack of Medical Necessity, 
													  Other Government Health Programs, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 26, 2019

				 Pharmaceutical manufacturer Avanir Pharmaceuticals will pay approximately $116 million to resolve civil and criminal charges related to its marketing of Nuedextra for off-label purposes and payment of kickbacks to prescribers and others.  The government alleged that Avanir marketed Nuedextra to long-term care facilities, suggesting that it could be used as an alternative to anti-psychotics for dementia patients, even though Nuedextra had only been approved by the FDA for treatment of particular symptoms secondary to a neurologic disease or brain injury.  In addition, Avanir provided certain physicians and other healthcare professionals with unlawful remuneration in the form of money, honoraria, travel, and food to induce them to write prescriptions for Nuedexta. The civil settlement for $103 million, which includes a five-year corporate integrity agreement, resolves whistleblower actions brought under federal and state False Claims Acts by former Avanir employees Kevin Manieri, Duane Arnold, and Mark Shipman.  Manieri will receive $12.4 million, and Arnold and Shipman will receive $5.4 million. In addition to the civil settlement, Avanir will pay a criminal penalty of $7.8 million, forfeit $5.1 million, and enter into a deferred prosecution agreement admitting to payment of kickbacks and requiring cooperation in ongoing in ongoing criminal investigations of individuals involved in marketing and prescribing Nuedextra.  Indictments against four individuals, including former Avanir employees and one of the top prescribers of Nuedexta in the country, were announced, charging the individuals with conspiracy to solicit, receive, offer and pay health care kickbacks.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Criminal Proceedings, 
													  FCA Federal, 
													  FCA State, 
													  Healthcare Fraud, 
													  Off-Label and Unapproved Use, 
													  Pharma Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 25, 2019

				 Mobile diagnostic service provider Trident USA Health Services LLC has agreed to pay $8.5 million to settle two whistleblower cases alleging violations of the False Claims Act.  Trident’s CIO, Ravi Srivastava, and a regional sales manager, Peter Goldman, had each filed their own qui tam suits alleging Trident had been engaged in a kickback scheme with skilled nursing facilities between 2006 and 2019.  For their efforts, Srivastava will receive $2 million and Goldman will receive $106,250 of the government’s recovery.  				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medicare, 
													  SNF, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 25, 2019

				 Dhanabapa LLC, doing business as E-Z Pharmacy, and owner Shardaben Patel have agreed to pay $1.1 million to settle allegations of defrauding Medicare and violating the False Claims Act in billing Medicare for prescription medications that were not actually dispensed.  The fraudulent billing occurred from 2012 to 2016 and included medications such as Advair Diskus, Humalog, Novolog, Renvela, and Lidoderm.  				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicare, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 20, 2019

				 Pradyumna Kumar Samal, the former CEO of two Bellevue, Washington IT firms, has been sentenced to more than seven years in prison for his role in a long-running H1-B visa fraud scheme.  Samal's companies, Divensi and Azimetry, were employment agencies in the business of providing IT workers to major corporate clients.  Samal would submit fraudulent applications on behalf of foreign workers, claiming that they were being brought to the U.S. to perform a specific job, and instructing them to lie in their own applications, when, in fact, after being admitted, the employees would be benched and unpaid until Samal's companies were able to place them at actual client jobs.  In addition, Samal's companies failed to pay employment taxes on behalf of the foreign workers, instead diverting those funds to his personal use.  				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Employment Tax Fraud, 
													  Tax Fraud, 
													  Visa Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 19, 2019

				 Following his conviction at trial in September 2018, Azam Doost, the owner of a marble mining company in Afghanistan, has been sentenced to 4.5 years in prison, and ordered to pay $8.9 million in forfeiture and restitution to the government.  Doost had been convicted for his role in fraudulently obtaining and failing to repay a $15.8 million loan from the Overseas Private Investment Corporation, a U.S. government agency, to Equity Capital Mining LLC, which Doost owned at the time.  				 					 

						
Tagged in:
													  Bribery and Bid-Rigging, 
													  Criminal Proceedings, 
													  Government Loan Programs, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 19, 2019

				 Selma, Alabama hospital Vaughan Regional Medical Center, together with two of its ER physicians and an affiliated company, will pay $1.45 million to resolve allegations that they violated the False Claims Act by having medical residents who were not fully licensed and credentialed provide emergency room services.  The hospital then falsified medical records and submitted claims to Medicare as if the services had been provided by a licensed physician.  The case originated with a qui tam action filed by Dr. Samuel Clemmons, who will receive $275,000.  				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Hospital Fraud, 
													  Improper Medical Personnel, 
													  Medical Billing Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 19, 2019

				 Following an earlier criminal plea, Hyundai Construction Equipment Americas Inc. and Hyundai Heavy Industries Co. Ltd have agreed to pay a $47 million civil penalty to resolve allegations that the company violated Title II of the Clean Air Act by marketing and selling heavy construction vehicles that did not comply with applicable emission standards.  Hyundai had stockpiled diesel engines that met outdated standards, including standards for nitrogen oxides (NOx) and particulate matter (PM), then illegally imported the non-compliant equipment to the U.S.  The EPA opened an investigation into Hyundai after receiving a whistleblower tip in 2015.  				 					 

						
Tagged in:
													  Environmental Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
September 18, 2019

				 Florida-based compounding pharmacy Diabetic Care Rx LLC, also known as Patient Care America, together with two of its executives, CEO Patrick Smith and VP of Operations Matthew Smith, and the private equity firm Riordan, Lewis & Haden Inc., will pay $21.36 million to resolve a case brought by two whistleblowers under the False Claims Act alleging that they paid unlawful kickbacks to secure referrals for patients covered by TRICARE, the federal healthcare program that covers military members and their families.  The pharmacy paid patient recruiters to target military members and their families for the prescription of compounded creams and vitamins formulated to ensure the highest possible reimbursement from TRICARE.  The marketers in turn paid doctors who issued the prescriptions, often without seeing or even speaking to the purported patients.  In addition, the pharmacy and marketing company often covered patient copayments through a sham charitable organization affiliated with the marketing company.  Private equity investor RLH was alleged to have known about and agreed to the kickback scheme.  Whistleblowers Marisela Medrano and Ada Lopez were, respectively, the former Director of Marketing and the Reimbursement Services Manager of PCA.  They will receive a yet-to-be-determined share of the U.S. recovery.  ; 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Compounding Pharmacy Fraud, 
													  Defendants, 
													  FCA Federal, 
													  Other Government Health Programs, 
													  Pharma Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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