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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.

				

			

			
						
					
			

	
		
		

			

				
				
April 17, 2023

				 Bill R. Miller, a construction company owner, will spend 78 months in prison and will pay nearly $1 million in restitution for a bid-rigging and bribery scheme perpetrated against California Department of Transportation (Caltrans). Caltrans contract manager and Miller-co-conspirator, Choon Foo “Keith” Yong, pleaded guilty to receiving bribes that included cash, wine, furniture, and remodeling service on his home. Yong will spend 49 months in prison and will pay over nearly $1 million in restitution as well. Miller, Yong, and their co-conspirators sought to corrupt the competitive bidding process to enrich themselves, while wasting taxpayer dollars on contracts not secured through free and fair competition. DOJ, DOJ				 					 

						
Tagged in:
													  Bribery and Bid-Rigging, 
													  Criminal Proceedings, 
													  Government Procurement Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 17, 2023

				 Sibley Hospital and parent company Johns Hopkins Health System will pay $5 million to resolve allegations of Stark Law violations. Over a four-year period, from 2008 to 2011, Sibley billed Medicare for ten cardiologists’ services to whom they were already paying compensation above fair market value. The Stark Law prohibits such an arrangement, to ensure that medical decision-making is not influenced by improper financial incentives but instead is based on the patient’s best interests. Sibley and Johns Hopkins self-disclosed the impropriety. DOJ				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 14, 2023

				 Rudean Weir and Jerome Weah will spend 30 and 46 months in prison, respectively, for defrauding the Enhanced One Shot Deal, a New York City Human Resources Administration program which provides cash assistance to homeless veterans seeking permanent housing. Weir and Weah submitted over 340 fraudulent EOSD applications using fake documentation and residency information and received approximately $5.4 million from the program as a result. Both defendants were ordered to pay $5.4 million in restitution. Weir will forfeit nearly $3.8 million, including his interest in two bank accounts, and six real estate properties. Weah will forfeit nearly $2.2 million, including his interest in two bank accounts and one real estate property. SNDY				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  FCA Federal, 
													  Government Programs Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 14, 2023

				 Nine defendants will spend a combined 70 years in prison for their respective roles in a $126 million compounding fraud scheme. The co-conspirators defrauded the Department of Labor’s Office of Workers’ Compensation Programs and TRICARE by submitting false claims and paying kickbacks to patient recruiters and physicians for prescribing certain medications, based not on medical necessity but instead on the drugs’ hefty reimbursement rates. The patients received the compounded medications via mail, despite never requesting, wanting, or needing them. DOJ				 					 

						
Tagged in:
													  Compounding Pharmacy Fraud, 
													  Criminal Proceedings, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medical Billing Fraud, 
													  Other Government Health Programs, 
													  Pharma Fraud, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 13, 2023

				 Adobe Inc. will pay $3 million to resolve false claims allegations it paid kickbacks under its Solution Partner program to companies that had a relationship with the government, potentially influencing federal purchases of Adobe software. Over a ten-year period, Adobe allegedly paid companies a percentage of the purchase price, running afoul of the anti-kickback provisions, and causing false claims to be submitted to federal agencies. The three whistleblowers—all former Adobe managers—will receive $555,000 for exposing the fraud. DOJ				 					 

						
Tagged in:
													  FCA Federal, 
													  Government Procurement Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 11, 2023

				 Rishi Shah, Shradha Agarwal, and Brad Purdy, all former executives of Outcome Health, were convicted in a $1 billion scheme to fraudulently obtain funds from their clients, lenders, and investors. Outcome installed tv screens and tablets in physicians’ offices around the US, and then sold non-existent advertising inventory to be shown on the installed screens. Outcome billed clients in full, despite under-delivering on the contract, and inflated metrics to lie about the frequency in which patients accessed the tablets. Using inflated engagement data and revenue numbers, they raised $110 million in debt financing in April 2016, $375 million in debt financing in December 2016, and $487.5 million in equity financing in early 2017. The trio faces decades in prison because of their fraud. DOJ				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 4, 2023

				 From 2014 to 2022, medical testing company Genotox Laboratories Ltd. paid kickbacks to their “1099” representatives, calculated as a percentage of the revenue Genotox received from Medicare, the Railroad Retirement Board, and TRICARE billings for testing orders facilitated or arranged for by these representatives. In addition to the kickbacks, Genotox also allowed providers to create “custom profiles” to pre-select the tests to order for their patients, often resulting in medically unnecessary testing, such as definitive drug testing for 22 or more drug classes. Genotox will pay $5.9 million, and Genotox’s former billing manager—the whistleblower in this qui tam action—will receive approximately $1 million. DOJ				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Laboratory and IDTF, 
													  Lack of Medical Necessity, 
													  Medicare, 
													  Other Government Health Programs, 
													  Provider Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
March 30, 2023

				 Pharmacist Gisele Nguyen will pay over $3.9 million for fraudulently billing Medicare for medications that were never dispensed. For at least a 5-year period, from 2014 to 2018, Nguyen, dba Natico Pharmacy, submitted fraudulent claims for prescriptions that were never dispensed, and inventory records reflected that the pharmacy did not purchase enough of the medications from wholesalers to meet the fraudulent demand. DOJ				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
March 29, 2023

				 Michigan-based Covenant Healthcare System and two physicians, neurosurgeon Dr. Mark Adams and electrophysiologist Dr. Asim Yunus, have agreed to pay $69 million and about $406,500 and $346,000 respectively to resolve allegations of violating the Anti-Kickback Statute, Stark Law, and False Claims Act.  Covenant allegedly provided Dr. Yunus and five other physicians medical directorship roles, employed Dr. Adams, forgave rent payments from another physician, and permitted a physician group to secure a lease on advantageous terms in exchange for referrals.  Covenant then submitted false claims based on those referrals to Medicare, Medicaid, and TRICARE.  The claims were first raised by Dr. Stacy Goldsholl in a qui tam suit; Goldsholl will receive over $12 million from the three settlements.  USAO EDMI				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medicare, 
													  Other Government Health Programs, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
March 29, 2023

				 A man who led a scheme to defraud New York’s Medicaid program has been sentenced to almost 8 years in prison, ordered to pay $8.5 million in restitution, and ordered to forfeit $8.5 million in ill-gotten gains.  While supervising more than a dozen others affiliated with KJ Transportation C Services Inc. (“KJ”), Julio Alvarado submitted or caused to be submitted false claims for transportation services to Medicaid beneficiaries, for which KJ was ultimately paid $20 million.  However, in many of those cases, the beneficiary was deceased or out of the country at the time of the alleged transport, or had never heard of or taken rides with KJ.  In other instances, the beneficiary received kickbacks from KJ in exchange for their Medicaid information.  USAO SDNY				 					 

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

					
	
							
	
		
		
	


 			


											

						

								

									
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