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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.

				

			

			
						
					
			

	
		
		

			

				
				
July 17, 2017

				 Ohio-based nursing home operators Foundations Health Solutions Inc., Olympia Therapy Inc. and Tridia Hospice Care Inc., and their executives Brian Colleran and Daniel Parker, agreed to pay roughly $19.5 million to resolve allegations they violated the False Claims Act by submitting to Medicare claims for medically unnecessary rehabilitation therapy services and for hospice services to patients not eligible for the Medicare benefit, and by soliciting and receiving kickbacks to refer patients from their skilled nursing facilities to home health care provider Amber Home Care LLC.  The allegations originated in two whistleblower lawsuits filed under the qui tam provisions of the False Claims Act by former Olympia employee Vladimir Trakhter and former Tridia employees Paula Bourne and La’Tasha Goodwin.  Mr. Trahkter will receive a whistleblower award of roughly $2.9 million and Ms. Bourne and Ms. Goodwin collectively will receive an award of roughly $740,000, all from the proceeds of the government’s recovery.  Whistleblower Insider				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Home Health and Hospice, 
													  Lack of Medical Necessity, 
													  Multiple Whistleblowers and First-to-File, 
													  SNF, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 14, 2017

				 Rodney Hesson and Gertrude Parker, owners of Nursing Home Psychological Services and Psychological Care Services, were respectively sentenced to 180 months and 84 months in prison and to respectively pay $13.8 million and $7.3 million in restitution for their involvement in a $25.2 million Medicare fraud scheme involving billing Medicare for psychological testing services that nursing home residents did not need or in some instances did not receive.  DOJ				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medicare, 
													  SNF, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 14, 2017

				 Narco Freedom, Inc., a former operator of outpatient chemical dependency clinics, Joining Hands Management Inc., an operator of short-term residences known as “three-quarter houses,” and Joining Hands co-owner Devorah Haigler, settled claims of violating the False Claims Act.  The government will receive a $50.5 million allowed claim in the Narco Freedom bankruptcy proceeding, and Joining Hands and Haigler will pay $300,000.  The government alleged the defendants engaged in a kickback scheme whereby Narco made monthly cash payments to Joining Hands in exchange for Haigler and others referring residents of Joining Hands three-quarter houses to NARCO outpatient programs.  The allegations originated in a whistleblower lawsuit under the qui tam provisions of the False Claims Act.  An unidentified whistleblower will receive an undisclosed whistleblower award from the proceeds of the government's recovery.  DOJ (SDNY)				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicare, 
													  Provider Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 13, 2017

				 The DOJ and HHS announced the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings.  DOJ				 					 

						
Tagged in:
													  Healthcare Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 13, 2017

				 New York podiatrist Perrin D. Edwards pled guilty to health care fraud for illegally charging Medicare and private insurance companies for podiatry services he never provided and agreed to pay $410,000 to resolve charges of violating the False Claims Act.  DOJ (NDNY)				 					 

						
Tagged in:
													  Medical Billing Fraud, 
													  Medicare, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 11, 2017

				 Mallinckrodt LLC, a pharmaceutical manufacturer and one of the largest manufacturers of generic oxycodone, agreed to pay $35 million to settle allegations it violated certain provisions of the Controlled Substances Act.  According to DOJ, it is the first settlement of its magnitude with a manufacturer of pharmaceuticals resolving nationwide claims the company did not meet its obligations to detect and notify DEA of suspicious orders of controlled substances such as oxycodone.  DOJ				 					 

						
Tagged in:
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 7, 2017

				 Wal-Mart Stores Inc. agreed to pay $1.65 million to resolve allegations it violated the False Claims Act by submitting pharmacy claims to California’s Medi‑Cal program not supported by applicable diagnosis and documentation requirements.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a Wal-Mart pharmacist.  The whistleblower will receive a whistleblower award of roughly $264,000 from the proceeds of the government's recovery.  DOJ (EDCA)				 					 

						
Tagged in:
													  Medicaid, 
													  Pharma Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 6, 2017

				 New Jersey-based Compassionate Care Hospice Group, Inc. agreed to pay $2.4 million to resolve charges that the company and its subsidiary Compassionate Care Hospice of Atlanta violated the False Claims Act and Stark Law by engaging in improper financial relationships with contracted physicians to induce them to refer patients.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former CCH Atlanta employees Cathy Morris and Josie King.  They will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (NDGA)				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Home Health and Hospice, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 6, 2017

				 Matthew Kolodesh, Alex Pugman, Svetlana Ganetsky, and Malvina Yakobashvili agreed to pay millions of dollars to settle False Claims Act allegations that they and their now-defunct company Home Care Hospice, Inc. falsely billed for hospice services that were either unnecessary or never provided.  The allegations originated in a whistleblower lawsuit under the qui tam provisions of the False Claims Act by former HCH employees Maureen Fox and Cathy Gonzales.  They will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (EDPA)				 					 

						
Tagged in:
													  FCA Federal, 
													  Home Health and Hospice, 
													  Medical Billing Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 6, 2017

				 Pennsylvania hospice company Compassionate Care of Gwynedd Inc., and a subsidiary of New Jersey-based Compassionate Care Hospice Group Inc., agreed to pay $2 million to resolve allegations it violated the False Claims Act by providing unnecessary hospice services.  The government alleged the company admitted patients by using a diagnosis of “debility” that was not medically justified.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act.  The whistleblowers will receive an award of more than $350,000 from the proceeds of the government's recovery.  DOJ (DNJ)				 					 

						
Tagged in:
													  FCA Federal, 
													  Home Health and Hospice, 
													  Lack of Medical Necessity, 
													  Medicare, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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