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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 5, 2017

				 Reliant Care Group, Reliant Care Management Company, Reliant Care Rehabilitative Services, and a number of Reliant affiliated skilled nursing facilities agreed to pay roughly $8.4 million to settle charges they violated the False Claims Act by billing Medicare for unnecessary physical, speech, and occupational therapy to nursing home residents.  DOJ (EDMO)				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
July 3, 2017

				 Prospect Mortgage Company agreed to pay roughly $4 million to settle charges of violating the False Claims Act stemming from Prospect’s participation in the Direct Endorsement Lender Program administered by the Federal Housing Administration and Department of Housing and Urban Development.  The government alleged Prospect falsely certified compliance with critical underwriting and quality control requirements when originating loans insured by the FHA and HUD resulting in substantial losses to the government when the loans defaulted and ripened into claims by Prospect for insurance payments from the government.  DOJ (NDGA)				 					 

						
Tagged in:
													  FCA Federal, 
													  Housing and Mortgage Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 30, 2017

				 Dawn Bentley, a Detroit-area medical biller, was sentenced to 50 months in prison and to pay roughly $3.3 million for her role in a $7.3 million Medicare and Medicaid fraud scheme involving medical services that were billed to Medicare and Medicaid but not rendered as billed.  DOJ				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Medicaid, 
													  Medical Billing Fraud, 
													  Medicare, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 30, 2017

				 Charlotte-Mecklenburg Hospital Authority (dba Carolinas Healthcare System) agreed to pay $6.5 million to resolve charges it violated the False Claims Act by “upcoding” claims for urine drug tests in order to receive higher payment than allowed for the tests.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Mark McGuire, a former laboratory director for CHS.  He will receive a whistleblower award of roughly $1.4 million from the proceeds of the government's recovery.  DOJ (WDNC)				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 29, 2017

				 Innovative Therapies, Inc. and its parent company Cardinal Health, Inc. agreed to pay roughly $2.7 million to settle charges they violated the False Claims Act by submitting false claims to Medicare through their marketing of certain negative pressure wound treatment devices as durable medical equipment when they knew these devices did not have the expected life of a durable device.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a former ITI employee.  The whistleblower will receive an award of $488,700 from the proceeds of the government's recovery.  DOJ (MDTN)				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 29, 2017

				 XIK, LLC, Honeywell International, Inc., and Domtar, Inc. agreed to pay $8.2 million to resolve a claim for natural resource damages at the St. Louis River/Interlake/Duluth Tar Superfund Site brought under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), also known as the Superfund Law.  The polluted site consists of 255 acres of land and river embayments located primarily in Duluth, Minnesota, and extends into the St. Louis River, including Stryker Bay.  DOJ				 					 

						
Tagged in:
													  Environmental Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 28, 2017

				 PAMC Ltd. and Pacific Alliance Medical Center Inc., which together own and operate Pacific Alliance Medical Center, an acute care hospital located in Los Angeles, agreed to pay $42 million to settle charges they violated the False Claims Act and the Stark Law by engaging in improper financial relationships with referring physicians.  These relationships took the form of (1) arrangements under which the defendants allegedly paid above-market rates to rent office space in physicians’ offices, and (2) marketing arrangements that allegedly provided undue benefit to physicians’ practices.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Paul Chan, who was employed as a manager by one of the defendants.  He will receive a whistleblower award of more than $9.2 million from the proceeds of the government's recovery.  DOJ				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Hospital Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 28, 2017

				 Charles G. Landry, D.O. agreed to pay $133,464 to resolve allegations he violated the False Claims Act by knowingly submitting claims for certain evaluation and management services not eligible for Medicare payment.  DOJ (DME)				 					 

						
Tagged in:
													  FCA Federal, 
													  Medicare, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 27, 2017

				 Dr. Anindya Sen, owner of Tennessee-based East Tennessee Cancer & Blood Center and East Tennessee Hematology Oncology and Internal Medicine, and his wife Patricia Posey Sen, agreed to pay $1.2 million to resolve charges they violated the False Claims Act by billing Medicare and Tennessee Medicaid for non-FDA approved anticancer and infusion drugs manufactured in foreign countries.  DOJ				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 26, 2017

				 Dr. Miguel Burgos, the medical director of four Florida infusion clinics, and Yosbel Marimon, the owner of the clinics, were sentenced respectively to 64 months and 90 months in prison for their roles in a $13.7 million Medicare fraud conspiracy that involved submitting claims for expensive infusion-therapy drugs that were never purchased, never provided and not medically necessary.  DOJ				 					 

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

					
	
							
	
		
		
	


 			


											

						

								

									
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