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DOJ Enforcement Actions

The Department of Justice 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 U.S. Attorneys Office 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.

May 14, 2021

Dusko Bruer, who owned and operated an agricultural machinery company, was sentenced to two years in prison and ordered to pay $2.8 million in restitution following his conviction on tax evasion charges.  Between 2003 and 2009, Bruer's company did not file or pay either corporate or employment taxes.  Bruer was not paid a salary; instead, he used funds from corporate bank accounts for personal expenses.  Bruer also failed to report foreign bank accounts that he owned and controlled, and to which he transferred millions of dollars between at last 2006 and 2015.   DOJ

May 14, 2021

Texas dentists Gunjan Dhir and Gaurav Puri and their affiliated management companies and practice groups will pay $3.1 million to resolve allegations that they fraudulently charged the Texas Medicaid program for pediatric dental services.  The investigation was initiated by the filing of a qui tam complaint by whistleblowers Sandy Puga, Nelda Torres-Brown, and Sonia Cardoso, who were former employees of defendants and will receive an undisclosed share the settlement.  Defendants allegedly billed for services that were not actually provided and/or misreported the provider of services by using erroneous Medicaid provider numbers.  USAO ND Texas

May 14, 2021

Swiss insurance company Swiss Life Holding AG and related entities will pay $77 million and enter into a deferred prosecution agreement admitting that they conspired with U.S. taxpayers to  conceal more than $1.452 billion in assets and income in offshore insurance policies and related policy investment accounts.  From 2005 to 2014, Swiss Life maintained approximately 1,608 Private Placement Life Insurance policies known as “insurance wrappers,” with associated policy investment accounts with Swiss Life entities identified as the owner, allowing U.S. taxpayers to hide undeclared assets and income and evade taxes.  Beginning in 2008, Swiss Life specifically marketed such policies to taxpayers withdrawing assets from UBS and other Swiss banks in response to offshore tax enforcement efforts aimed at those bank.  DOJ; USAO SDNY

May 13, 2021

Financial services company State Street Corporation will pay a $115 million criminal penalty and enter into a deferred prosecution agreement following its voluntary disclosure to authorities that, over the course of 17 years, the bank defrauded its clients out of $290 million.  State Street  admitted that it secretly marked up “out-of-pocket” (OOP) expenses charged to clients, despite telling clients that OOP expenses were passed through without markups. State Street executives took steps to conceal the mark-ups from clients, including by misleading clients when they inquired about what they were being charged for OOP expenses. As part of the settlement, defendant agreed to cooperate with ongoing investigations, to enhance its compliance program, and to retain an independent corporate compliance monitor for a period of two years. DOJ

May 12, 2021

Technology company MobileActive will pay $500,000, and its principal Katrin Verclas will serve two years in prison in civil and criminal resolutions arising from the defendants' scheme to defraud the U.S. State Department's Bureau of Democracy, Human Rights, and Labor ("DRL").  In 2010, MobileActive applied for and was awarded a $1.4 million DRL grant to develop and promote a "mobile security toolkit" for human rights organizations and activists to use in assessing and mitigating risks associated with mobile communications. After claiming $1.2 million in grant funds, Verclas failed to respond to requests for information from the State Department; she has admitted that she failed to comply with grant requirements, and directed the funds to her personal use while concealing the nature of the transactions from MobileActive's bank.  USAO MD

May 10, 2021

The University of Miami, which operates multiple hospitals and other healthcare facilities, will pay $22 million to resolve claims arising from allegedly fraudulent billing submitted to federal healthcare programs for laboratory services.  The university was alleged to have billed certain laboratory tests as having been provided at hospital facilities instead of at physician offices, without satisfying the requirements for that more costly hospital facility billing, including notice requirements.  In addition, the university was alleged to have performed and billed for a pre-set panel of tests for all kidney transplant patients, although not all included tests were medically necessary.  Finally, the university and Jackson Memorial Hospital, which jointly operated the kidney transplant program, were alleged to have violated related party restrictions by billing for pre-transplant laboratory tests ordered by JMH from the university, and JMH will pay an additional $1.1 million to settle these allegations.  The settlement resolves claims made in three separate qui tam lawsuits; the whistleblower's share has not yet been determined.  DOJ; USAO SD FL

May 10, 2021

Iowa skilled nursing facility Dubuque Specialty Care, owned by Care Initiatives, will pay $214,200 to resolve claims that they received federal Medicaid funds during a COVID-19 outbreak at the facility while failing to adhere to requirements for infection control, including procedures for screening symptomatic employees for COVID-19.  USAO ND Iowa

May 5, 2021

Neurosurgical Associates, LTD and Dignity Health, d/b/a St. Joseph’s Hospital, have agreed to a $10 million settlement and five-year corporate integrity agreement to resolve allegations of violating the federal False Claims Act.  According to whistleblower Dr. Bruce P. Kingsley, Neurological Associates and St. Joseph’s Hospital improperly billed Medicare for certain doubly and triply concurrent and overlapping surgeries.  USAO AZ

May 4, 2021

Delaware-based pharmaceutical company Incyte Corporation has agreed to pay $12.6 million to resolve allegations of violating the Anti-Kickback Statute and False Claims Act in connection with its myelofibrosis drug, Jafaki.  Despite federal laws against illegal remuneration to federal healthcare program beneficiaries, Incyte allegedly wielded its influence as the sole donor of a foundation to coerce the foundation into illegally covering the copays of Medicare and TRICARE patients taking Jafaki.  The misconduct continued from 2011 through 2014 before it was revealed in a qui tam suit by former compliance executive turned whistleblower, Justin Dillon.  Dillon will receive approximately $3.59 million for his efforts.  DOJ; USAO EDPA

May 4, 2021

After being convicted of running a $11 million healthcare fraud scheme, Brenda Rodriguez, the owner and operator of Texas-based QC Medical Clinic, has been ordered to spend 25 years in prison, followed by 3 years of supervised release.  As shown by evidence presented at trial, Rodriguez’s scheme involved paying doctors to approve Medicare beneficiaries for home health services, selling the approvals to various home health providers, and causing the providers to bill Medicare for services that were medically unnecessary, never provided, and/or arose from illegal inducements.  USAO SDTX
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