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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.

May 19, 2022

Healthcare testing company VirtuOx, Inc. agreed to pay $3.15 million to resolve claims brought in an action initiated by a whistleblower alleging that falsely billed Medicare for pulse oximetry testing.  VirtuOx allegedly reported San Francisco as the location for overnight pulse oximetry testing when, in fact, no services were performed at that location, but that location resulted in a higher Medicare reimbursement.  In addition, VirtuOx allegedly billed Medicare for both oxygen “spot checks” and overnight pulse oximetry testing, when only the overnight testing was performed.  The whistleblower, Amber Watt, will receive an award of $630,000.  USAO SD FL

May 18, 2022

Pat Truglia will spend 120 months in prison, forfeit over $9.4 million, and will pay restitution of $33.7 million for conspiring to defraud Medicare, TRICARE, and CHAMPVA, among others, of approximately $50 million through their fraudulent billing scheme. The scheme involved offering, paying, soliciting, and receiving kickback for durable medical equipment—in this case, braces. Truglia and his conspirators obtained DME orders for Medicare and other federal healthcare program beneficiaries by running multiple call centers, which paid kickbacks and bribes to telemedicine companies, who then paid doctors to write medically unnecessary orders. The orders were filled by Truglia’s companies, who then fraudulently billed the healthcare programs. USAO NJ

May 18, 2022

Seven companies in South Korea have agreed to a joint settlement of $3.1 million to resolve allegations that they conspired to suppress and eliminate competition in bidding on 15 contracts for construction and engineering work on U.S. military bases in South Korea awarded by the U.S. Army Corps of Engineers between 2016 and 2019.  The government alleged that as a result of the bid-rigging by the companies, Korea Engineering Consultants Corporation, Yul Lim Construction Co. Ltd., Shin Woo Construction & Industrial Co. Ltd., Seongbo Const. Ind. Co. Ltd., Wooseok Construction Co. Ltd., Yuil Engineering and Construction Co., and Seokwang Development Co. Ltd., the government paid substantially more for services performed under the contracts than it otherwise would have.  DOJ

May 18, 2022

Peter Bolos and Michael Palso, owners of Synergy Pharmacy, were sentenced to 14 years and 33 months in prison, respectively, and each will pay $24.6 million in restitution for defrauding pharmacy benefit managers into authorizing millions of dollars in claims paid to pharmacies controlled by the defendants. Bolos will forfeit an additional $2.5 million. The conspiracy involved cold-calling patients and deceiving them into accepting certain drugs (i.e., pain creams, scar creams, and vitamins) and providing their personal insurance information to receive them. The scheme impacted both private and public insurers, including Medicaid and TRICARE. DOJ, USAO EDTN

May 17, 2022

Allianz Global Investors U.S. LLC pleaded guilty to securities fraud and agreed to pay a criminal fine of $2.3 billion, an SEC penalty of $675 million, and over $5 billion in disgorgement and restitution to victims.  Three former AGI senior portfolio managers, Gregoire Tournant, Trevor Taylor, and Stephen Bond-Nelson, also pleaded guilty to related charges and will be sentenced at a later date.  As part of its plea, AGI admitted that between 2014 and 2020, AGI and the individual defendants made false and misleading statements to current and prospective investors in AGI’s Structured Alpha Funds which understated downside risks and overstated the level of independent risk oversight over the funds.  While the funds promised risk management and hedging, the actual investment strategy prioritized returns over risk management, and the promised hedging positions were not purchased.  To conceal losses and understate the magnitude of the actual risks, defendants fraudulently altered numerous financial reports and other information provided to investors.  The scheme was exposed when the funds experienced billions in losses during the 2020 COVID-related market volatility. With its guilty plea, AGI US is disqualified from providing advisory services to U.S.-registered investment funds for the next ten years, and will exit the business of conducting these fund services.  SEC; DOJ; SDNY

May 16, 2022

Oklahoma Heart Hospital South, LLC paid over $1.1 million to settle alleged violations of the False Claims Act. An OHHS internal review and audit exposed Medicare billing irregularities related to their Intensive Cardiac Rehabilitation services, which they self-disclosed to the government. The US government’s follow-up investigation, with which OHHS cooperated, revealed that for a 6-year period—from 2013 to 2019—OHHS physicians failed to complete and update patients’ individualized treatment plans for care that lasted longer than 30 days. The settlement is not an admission of OHHS’ liability, and the government did not concede any of its claims. WDOK USAO

May 13, 2022

Hensel Phelps Construction Company has agreed to pay $2.8 million to resolve allegations of violating the False Claims Act in connection with a federal subcontract designated for service-disabled, veteran-owned small businesses (SDVOSB).  Under a 2011 contract with the General Services Administration to construct a building in Washington, D.C., Hensel Phelps was required to set aside subcontracts for SDVOSBs and other small businesses.  According to qui tam plaintiff Fox Unlimited Enterprises, LLP, the company instead made arrangements with another large business to provide equipment and installation services, and used a SDVOSB in name only.  USAO NDNY, USAO EDWA

May 9, 2022

Prism Behavioral Solutions has agreed to pay $650,000 to resolve allegations of violating the federal and California False Claims Acts by billing California’s Medicaid program for services not provided to autistic children and young adults.  The whistleblower in this case, Diana Mason, is a behavioral analyst employed by Prism, and will receive a $170,000 share of the settlement.  USAO SDCA; CA AG

May 5, 2022

Robert Narvett will spend 15 years in prison for wire fraud and money laundering. Narvett, of Appleton, WI, defrauded nearly 70 different victims of over $2 million, in the end ruining credit scores, rendering victims unable to afford basic life necessities, and having to return to the workforce after retiring. USAO EDWI

May 5, 2022

Kohl’s and Walmart will pay $5.5 million in penalties for alleged violations of the Textile Fiber Products Identification Act, Textile Rules, and FTC Act for deceptively advertising rayon products as being made of bamboo, for falsely attesting to their environmentally-friendly qualities. They engaged in this behavior despite being warned by the FTC in 2010 that advertising rayon products as bamboo products violated the Textile Rules and FTC Act. DOJ
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