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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 19, 2018

				 San Diego-based diagnostic lab testing company Biotheranostics Inc. agreed to pay $2 million to settle claims it violated the False Claims Act by submitting claims to Medicare for Breast Cancer Index (BCI) tests not reasonable and necessary for the diagnosis and treatment of breast cancer. DOJ				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 16, 2018

				 Aharon Aron Krkasharyan, a former employee Mauran Ambulence Inc., was sentenced to 36 months in prison and pay roughly $485,000 for his role in a scheme that resulted in more than $1.1 million in fraudulent claims to Medicare.  Krkasharyan admitted he conspired with other Mauran employees to submit claims to Medicare for ambulance transportation services for individuals who did not need such services. Krkasharyan also admitted that he and his co-conspirators instructed Mauran emergency medical technicians to conceal the patients’ true medical conditions by altering paperwork and creating fraudulent reasons to justify the ambulance services. DOJ				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medical Billing Fraud, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 12, 2018

				 Arizona-based Banner Health agreed to pay over $18 million to settle claims that 12 of its hospitals in Arizona and Colorado submitted false claims to Medicare by admitting patients who could have been treated on a less costly outpatient basis. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Banner employee Cecilia Guardiola. She will receive a whistleblower award of roughly $3.3 million from the proceeds of the government’s recovery. DOJ				 					 

						
Tagged in:
													  FCA Federal, 
													  Hospital Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 12, 2018

				 Florida-based respiratory equipment supplier Rotech Healthcare Inc. agreed to pay $9.68 million to settle claims of violating the False Claims Act by submitting claims for portable oxygen contents to Medicare for beneficiaries who did not use or require them. The Company further admitted to billing Medicare regardless of whether such contents were delivered. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Rotech employee Janet Hale. She will receive a whistleblower award of $1,645,600 from the proceeds of the government’s recovery. DOJ				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 10, 2018

				 Connecticut-based medical practice World Health Clinicians, Inc., its CEO Scott Gretz, and former World Health physician Gary Blick agreed to pay roughly $650,000 to settle claims they violated the False Claims Act by submitting claims for physical therapy and other covered services when in fact the patients received massages provided by a massage therapist. DOJ (CT)				 					 

						
Tagged in:
													  FCA Federal, 
													  Provider Fraud, 
													  Upcoding, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 5, 2018

				 A judgement for roughly $30.6 million was entered against Texas-based BestCare Laboratory Services LLC and its founder Karim Maghareh for violating the False Claims Act by billing the government for thousands of miles that were not actually travelled. Dr. Richard Drummond discovered the fraud after hiring a former BestCare employee and learning of their billing practices. He then filed a whistleblower lawsuit under the qui tam provisions of the False Claims Act. He will receive a whistleblower reward from the proceeds of the judgment. DOJ (SDTX)				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 5, 2018

				 The Estate of Dr. Leroy Pelicci, former owner of Scranton-based Pelicci Pain Relief Center, agreed to pay $625,000 to settle claims he violated the False Claims Act by submitting improper claims for payment to the Department of Labor Office of Workers’ Compensation Programs under the Federal Employees Compensation Act and the Federal Employees Health Benefits Program for trigger point injections, which were upcoded to receive a higher reimbursement amount than permitted. DOJ (MDPA)				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Other Government Health Programs, 
													  Provider Fraud, 
													  Upcoding, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 3, 2018

				 Norwegian NGO Norwegian People’s Aid, which receives funding from the US Agency for International Development, agreed to pay $2 million to settle claims it violated the False Claims Act by providing material support to Iran, Hamas, the Popular Front for the Liberation of Palestine (“PFLP”), and the Democratic Front for the Liberation of Palestine (“DFLP”), contrary to federal funding requirements. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. DOJ (SDNY)				 					 

						
Tagged in:
													  Contract Non-Compliance, 
													  FCA Federal, 
													  Grant and Research Fraud, 
													  International Whistleblowers, 
													  Whistleblower Case, 
													  Whistleblower Eligibility, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 2, 2018

				 Utah construction companies Big-D Construction Corp. and Creative Times Day School, Inc. agreed to pay roughly $1 million and $150,000 respectively to settle claims they violated the False Claims Act by violating the terms of a Small Business Administration (SBA) program for small and disadvantaged businesses. DOJ (Utah)				 					 

						
Tagged in:
													  FCA Federal, 
													  Government Procurement Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 2, 2018

				 $130,752 to settle allegations that two companies, Sanders Oil & Gas, LLC and Sanco Operating Company agreed to pay roughly $130,000 to settle claims it violated the False Claims Act by failing to pay money owed to the Department of the Interior’s Office of Natural Resources Revenue for natural gas produced from a federal lease located in New Mexico. DOJ (CO)				 					 

						
Tagged in:
													  Environmental Fraud, 
													  FCA Federal, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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