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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.

				

			

			
						
					
			

	
		
		

			

				
				
February 6, 2017

				 U.S. hospital service provider TeamHealth Holdings (as successor in interest to IPC Healthcare Inc., f/k/a IPC The Hospitalists Inc.), agreed to pay $60 million to resolve allegations it violated the False Claims Act by billing Medicare, Medicaid, the Defense Health Agency and the Federal Employees Health Benefits Program for higher and more expensive levels of medical service than were actually performed (a practice known as “up-coding”).  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dr. Bijan Oughatiyan, a physician formerly employed by IPC as a hospitalist.  He will receive a whistleblower award of roughly $11.4 million.  DOJ				 					 

						
Tagged in:
													  FCA Federal, 
													  Medicaid, 
													  Medicare, 
													  Other Government Health Programs, 
													  Upcoding, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 6, 2017

				 New Jersey-based Para-Plus Translations, Inc., together with its owners Robert Santiago, III and Sonia Santiago, agreed to pay $1.5 million to settle charges of violating the False Claims Act by submitting invoices to federal and state governmental clients that purposefully overstated the travel time and mileage incurred by its interpreters.  The allegations originated in a whistleblower lawsuit filed by Kimberly Martin under the qui tam provisions of the False Claims Act.  She will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (WDPA)				 					 

						
Tagged in:
													  Falsifying Invoices, 
													  FCA Federal, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 2, 2017

				 Pain management physician Dr. Robert Windsor, owner of National Pain Care, Inc. which owns pain management clinics in Georgia and Kentucky, agreed to the entry of a $20 million consent judgment to resolve allegations he violated the False Claims Act by billing federal health care programs for surgical monitoring services he did not perform and for medically unnecessary diagnostic tests.  The allegations originated in two whistleblower lawsuits filed under the qui tam provisions of the False Claims Act by Kris Frankenberg, Stephanie Herder and Bradley Davis.  They will receive a yet-to-be-determined whistleblower award from the proceeds of the government’s recovery.  Whistleblower Insider				 					 

						
Tagged in:
													  FCA Federal, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Medical Billing Fraud, 
													  Medicare, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 1, 2017

				 Jackson State University agreed to pay $1.17 million to settle charges it violated the False Claims act by mismanaging National Science Foundation grants.  Specifically, a 2012 NSF audit identified salary and non-salary expenditures by Jackson State that were unallowable, not allocable, and/or had insufficient, inadequate and/or no supporting documentation.  A subsequent NSF investigation determined that, in preparation for the audit, and subsequently in response to the preliminary audit findings, Jackson State fabricated time and effort reports and provided them to the auditors, and in some instances presented inadequate and/or no supporting documentation.  DOJ (SDMS)				 					 

						
Tagged in:
													  Defendants, 
													  Education Fraud, 
													  FCA Federal, 
													  Grant and Research Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 1, 2017

				 Florida urologist Dr. Meir Daller agreed to pay $3.81 million to resolve allegations he violated the False Claims Act by causing claims to be submitted to federal health care programs for laboratory tests that were not medically necessary.  Dr. Meir practices as part of Gulfstream Urology, a division of 21st Century Oncology, LLC, which is a nationwide provider of integrated cancer care services.  The government previously entered into settlements relating to similar allegations with 21st Century Oncology for $19.75 million and urologists David Spellberg and Robert Scappa for $1,050,000 and $250,000, respectively.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Mariela Barnes, a former medical assistant for Dr. Spellberg at Naples Urology Associates, also a division of 21st Century Oncology.  She will receive a whistleblower award of $571,500 from the proceeds of the government's recovery in this settlement.  This is in addition to a $3,437,000 million award she already received from the prior settlements.  DOJ (MDFL)				 					 

						
Tagged in:
													  FCA Federal, 
													  Laboratory and IDTF, 
													  Lack of Medical Necessity, 
													  Medicare, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
February 1, 2017

				 Iowa nursing facility the Abbey of Le Mars, Inc., and other individuals with financial interests in the Abbey’s operations, agreed to pay $100,000 to settle allegations they violated the False Claims Act by submitting or causing claims to be submitted to Medicaid when the care provided to nursing facility residents was so grossly substandard it was worthless and effectively without value.  DOJ (NDIA)				 					 

						
Tagged in:
													  FCA Federal, 
													  Medicaid, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 27, 2017

				 Brooklyn residents Olga Proskurovsky, Yuriy Omelchenko and Isak Aharanov pleaded guilty in connection with a health care fraud scheme involving two Brooklyn clinics that caused approximately $55 million in false claims to Medicare and Medicaid.  They agreed to forfeiture money judgments in the amount of roughly $17 million.  Proskurovsky served as a medical biller and Omelchenko worked as a therapist manager at Prime Care on the Bay LLC and Bensonhurst Mega Medical Care P.C. where they assisted in a scheme to defraud the Medicare and Medicaid programs in which patients subjected themselves to medically unnecessary health services, including physical and occupational therapy, provided by unlicensed staff.  DOJ				 					 

						
Tagged in:
													  Improper Medical Personnel, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Medicare, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 25, 2017

				 Rodney Hesson and Gertrude Parker, owners of several psychological services companies, were convicted for their involvement in a $25.2 million Medicare fraud scheme carried out through eight companies at nursing homes in four states in the Southeastern United States.  According to evidence presented at trial, the defendants’ companies contracted with nursing homes for psychological testing services the nursing home residents did not need or did not receive.  DOJ				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Medicare, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 23, 2017

				 Washington River Protection Solutions LLC agreed to pay $5.275 million to settle allegations it knowingly submitted false claims to the Department of Energy for overtime and premium pay and also failed to comply with the contract’s internal audit requirements in connection with work performed at DOE's Hanford Nuclear Site known as the Tank Farms.  DOJ				 					 

						
Tagged in:
													  Contract Non-Compliance, 
													  Falsifying Invoices, 
													  Government Procurement Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 19, 2017

				 The University of Pennsylvania Health System agreed to pay $845,000 to settle charges of violating the False Claims Act by improperly billing Medicare for stent procedures two interventional cardiologists performed at Pennsylvania Hospital.  DOJ (EDPA)				 					 

						
Tagged in:
													  FCA Federal, 
													  Medical Billing Fraud, 
													  Medicare, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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