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DOJ Principal Deputy Assistant Attorney General Credits Whistleblowers, Identifies 2024 Priorities

Posted  02/27/24
Department of Justice Seal Logo
DOJ Principal Deputy Assistant Attorney General Brian Boynton recently spoke at the 2024 Federal Bar Association’s Qui Tam Conference.  Here are a few key takeaways from his remarks, which can be found here.
  1. Crediting Whistleblowers. Boynton lauded whistleblowers, calling them “a critical source of [DOJ’s] enforcement efforts,” and he thanked them and their counsel for their efforts, adding that the DOJ...

Scoundrel Spotlight - COVID-19 Fraudster Lourdes Navarro

Posted  10/9/23
Laboratory Worker Taking a Swab Test
This week's Scoundrel in the Spotlight is Lourdes Navarro and her husband Imran Shams.  The married pair ran the LA County medical lab Clinical Laboratory Inc. (also called Health Care Providers Laboratory).  Their lab performed COVID-19 screening tests primarily for nursing homes and other facilities catering to the elderly population.  Last Thursday (October 5), Navarro pleaded guilty to fraudulently billing the...

GAO Highlights Massive Fraud of Government Funds for Unemployment Insurance During COVID Pandemic

Posted  09/14/23
Visualization of COV ID-19 Virus
On September 12, 2023, the United States Government Accountability Office (GAO) published a report estimating between $100 billion and $135 billion in unemployment insurance fraud during the COVID-19 pandemic (from April 2020 to May 2023).  This represents roughly 11-15% of the total unemployment insurance benefits paid during the pandemic, or as the Washington Post put it, the GAO “found the theft encompassed...

DOJ Smackdown of COVID-19 Fraud

Posted  08/25/23
Virus with COVID-19 Lettering Over
On Wednesday (August 23), the Department of Justice (DOJ) announced significant progress in its ongoing effort to combat COVID-19 fraud.  The agency reported a nationwide, coordinated three-month sweep resulting in more than 700 enforcement actions involving hundreds of defendants, covering more than $800 million in alleged COVID-19 fraud. According to the government, these actions largely involved going after...

DOJ FY2022 Annual Fraud Report Shows $2.2 Billion in Total Recoveries, with $1.9 Billion Thanks to Whistleblowers - But There are Reasons for Concern

Posted  02/8/23
DOJ Headquarters building seen from low angle
The Department of Justice released its annual report of civil recoveries for fraud and false claims against the U.S., showing $2.2 billion in settlements and judgments for the fiscal year ending September 2022. The data released by DOJ show the critical role that whistleblowers play in securing these recoveries for the government:  of the $2.2 billion recovered, $1.96 billion – 89% – was recovered in cases...

Telehealth Boomed During the Pandemic - and so Did Telehealth Fraud

Posted  08/24/22
Doctor with stethoscope on computer screen
Prior to the pandemic, telehealth was basically nonexistent, with one study clocking the percentage of “virtual” doctors’ visits before Covid-19 at zero percent. At the time, America’s largest insurer, Medicare, only covered telemedicine in limited circumstances that usually still involved a visit to a healthcare facility. Medicare’s coverage limitations demonstrated the Department of Health and Human...

DOJ Ramps Up Enforcement Against COVID-19 Fraud

Posted  04/25/22
COVID-19-Fraud-Whistleblower-Lawyers
Even as mask restrictions are being relaxed in most parts of the country, the U.S. Department of Justice is ramping up its oversight of federal funds spent to fight the COVID-19 pandemic.  Just last week, DOJ announced criminal charges against 21 defendants in nine federal districts for their alleged participation in COVID-19 fraud schemes that resulted in over $149 million in false billings to federal programs. 

Catch of the Week: A Tale of Two Cons

Posted  02/10/22
Money Rolls
The start of February 2022 brought resolutions in two different COVID-19 fraud cases, one in the Paycheck Protection Program and one in the Pandemic Unemployment Assistance program. Both involved scammers with previous criminal records who fraudulently obtained COVID relief money. The Department of Justice continues to prioritize enforcement against fraudsters who take advantage of the Paycheck Protection Program,...

Top Ten Financial and Healthcare Fraud Prison Sentences of 2021

Posted  01/28/22
handcuff and money
Individuals involved in financial and healthcare fraud schemes face not just civil liability, but also criminal penalties – including prison time. In 2021, the Department of Justice obtained substantial prison sentences in a myriad of cases involving healthcare and financial frauds, many of which involved convictions of the type of fraudulent schemes that whistleblowers report. Whistleblowers play an essential role...

Catch of the Week: Classic Medicare Fraud

Posted  11/5/21
medicare dollars
For those like your correspondents who spend their days deep in the weeds of complex Medicare fraud, it’s a delight when something refreshingly simple comes along.  Thanks to Billy Joe Taylor of Arkansas, we can relax this Friday with a cool glass of straightforward Medicare fraud.  For allegedly making $100 million in claims to CMS for tests that were not ordered or ever performed, he is our Catch of the...
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