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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.

November 20, 2020

Information technology contractor Cognosante, LLC will pay $19 million to resolve allegations that it violated the False Claims Act by overcharging the government under two GSA Multiple Award Schedule contracts.  The settlement came after Cognosante disclosed to the U.S. that it provided false information concerning its commercial discounting practices during contract negotiations and, during contract performance, charged the government for labor that failed to meet the qualifications set forth in the contracts.  DOJ; USAO DC

November 16, 2020

Seattle’s Group Health Cooperative, now part of Kaiser, will pay $6.375 million to settle allegations in a whistleblower suit that it falsely reported unsupported diagnosis codes to Medicare in order to receive inflated payments.  The suit alleges that GHC utilized the services of a coding review company, DxID, that proposed unsupported diagnosis codes, which GHC knowingly submitted to CMS as part of seeking higher payment for the affected Medicare Advantage beneficiaries.  Whistleblower Teresa Ross, represented by Constantine Cannon, will receive approximately $1.5 million.  DOJ

November 5, 2020

Lawrence Gerrans, the former CEO of medical device start-up Sanovas, was sentenced to over 11 years in prison following his conviction at trial on charges arising from his diversion of funds from Sanovas to his personal use, including by transferring nearly $3 million to shell companies he controlled.  During the criminal investigation, Gerrans provided false documents to the FBI, tampered with a witness, and violated a court-ordered bond condition.  ND Cal

November 3, 2020

Illinois-based charter school management company Concept Schools, NFP, will pay $4.5 million to settle allegations that it violated the False Claims Act by rigging the bidding process for E-Rate contracts with its network of charter schools between 2009 and 2012 so that its preferred technology vendors received contract awards, despite the fact that they provided equipment at higher prices than those approved by the FCC for equipment with the same functionality.  DOJ

November 2, 2020

Hospital system Memorial Health Services will pay a total of $31.5 million after self-disclosing that it overcharged California’s Medicaid program, Medi-Cal, for outpatient prescription drug reimbursements under the 340B Drug Pricing Program.  Memorial Health billed Medi-Cal for outpatient drugs at its usual and customary rate, rather than the lower “actual acquisition costs,” as required under the 340B Drug Pricing Program. California will receive $18.9 million of the settlement, and the federal government will receive $12.6 million.  Cal; CD Cal

October 30, 2020

Days and Towers, LLC will pay over $800,000 to resolve charges that it violated the False Claims Act between 2015 and 2019 through its submission of false tariff schedules to reduce its customs obligations on imported products.  USAO PR

October 29, 2020

Medtronic has agreed to pay over $9.2 million to resolve allegations of violating the False Claims Act and CMS’s Open Payments Program by paying kickbacks to a South Dakota-based neurosurgeon, Wilson Asfora, M.D., in order to induce sales of its SynchroMed II implantable intrathecal infusion pumps.  According to the government, Medtronic allegedly sponsored nine years’ worth of events at a restaurant owned by Asfora, and to which Asfora would invite his acquaintances, business partners, trusted colleagues, and referral sources.  For his role in the kickback scheme, Asfora has been named in a separate FCA lawsuit, which the United States joined last November.  USAO SD

October 27, 2020

In what appears to be one of the largest Post-9/11 G.I. Bill fraud cases ever prosecuted in the country, the owner of a technical training school in San Diego has been sentenced to over three years in prison and ordered to pay almost $30 million in restitution for defrauding the VA out of almost $30 million.  To conceal the fact that Blue Star Learning had close to 100% veteran students—which violated the VA’s “85/15 Rule” that required 85% non-veteran students per course—and to conceal the fact that most of the school’s graduates did not obtain jobs in the fields they were trained in, owner Nimesh Shah allegedly created and submitted elaborate student and graduate files to the California State Approving Agency for Veterans Education (CSAAVE) and the VA.  Because he knew the fake students and employers could be contacted by the agencies, Shah went so far as to have an employee buy 30 mobile phones outfitted with fake company voicemails, as well as hire overseas individuals to man fake email addresses that he created.  As a result of the fraud scheme, Blue Star Learning was paid over $11 million in tuition and over $18 million in housing allowances and stipends.  USAO SDCA

October 27, 2020

Chicago-based distillery Beam Suntory Inc. (Beam) has agreed to pay over $19.5 million to settle allegations of paying bribes to Indian government officials between 2006 to 2012, in violation of the Foreign Corrupt Practices Act (FCPA).  At least some of the bribes were authorized by a high-level regional executive and paid by third parties.  Additionally, Beam intentionally failed to implement internal controls to prevent such conduct, as well as falsified books and records to conceal the bribes after they were paid.  As part of the settlement, Beam admitted to the charges and agreed to a three-year deferred prosecution agreement.  USAO NDIL

October 22, 2020

Guild Mortgage Company, based in San Diego, has agreed to pay $25 million to resolve whistleblower-brought allegations of knowingly breaching material program requirements in connection with mortgages insured by the Federal Housing Administration (FHA).  As a participant of the FHA’s mortgage insurance program, Guild had the authority to originate and underwrite mortgages without government review for compliance with program rules. According to the former head of quality control, Kevin Dougherty, Guild failed to comply with those rules when it knowingly approved ineligible loans that later defaulted.  Dougherty will receive a relator’s share of nearly $5 million.  USAO SDCA
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