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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 27, 2020

North Carolina based clinical laboratory Genova Diagnostics Inc. will pay up to $43 million to resolve a lawsuit brought by whistleblower Darryl Landis, who will receive up to $6 million.  The laboratory allegedly billed Medicare, TRICARE, and other government healthcare programs for IgG allergen, “NutrEval,” and “GI Effects” lab tests that were not medically necessary, and also paid unlawful compensation to three phlebotomy vendors in violation of the Stark Law  The settlement amount consists of the forfeiture of $17 million in claim funds held in suspension by Medicare and TRICARE, as well as an additional $26 million to be paid based on certain financial contingencies over the next five years.  DOJ; USAO WD NC

April 21, 2020

KPMD, Inc., technology company in California, has been ordered to pay $1.7 million in restitution for defrauding Medicare and Medicaid.  According to the DOJ’s press release, KPMD entered into a contract with Ohio-based Southwest Regional Medical Center in 2011 where it agreed to implement an electronic health records software program for the hospital in exchange for government incentive payments under the federal Health Information Technology for Economic and Clinical Health Act (HITECH Act).  After KPMD’s CEO purchased the hospital, however, the company falsely attested to meeting criteria for the incentive payments even though the hospital was winding down operations.  $1.3 million of the settlement will go to Medicare, with the remaining $800,000 to go to Medicaid.  USAO SDOH

April 15, 2020

A Florida-based reference laboratory, pain clinic, and two former executives have agreed to pay $41 million to settle claims of defrauding Medicaid, Medicare, TRICARE, and other government health programs by billing for medically unnecessary urine drug tests between 2010 to 2017.  Led by Michael T. Doyle and Christopher Utz Toepke, the defendants allegedly had a policy of automatically ordering both presumptive and definitive urine drug tests for all patients at every visit regardless of need, with Toepke’s Tampa Pain Relief Centers Inc. performing all presumptive tests, and Doyle’s Logan Laboratories Inc. performing all definitive tests.  The alleged False Claims Act violations were eventually brought to light in two qui tam cases; the whistleblowers of those cases will split a relator’s share of approximately $7.79 million.  DOJ; EDPA; MDFL; FL

April 15, 2020

Rice University in Texas has agreed to pay more than $3.7 million to settle claims of improperly charging unrelated expenses to National Science Foundation (NSF) research and development awards, in violation of the False Claims Act.  From 2006 to 2018, Rice University allegedly falsely certified that they were complying with NSF award terms and conditions, when in fact they were knowingly and improperly charging graduate students’ teaching stipends and unrelated administrative charges to the grants.  USAO SDTX

April 14, 2020

A chain of nine skilled nursing facilities operating in seven states has agreed to pay $10 million to settle a whistleblower-brought suit alleging violations of the False Claims Act.  In the suit, former employees Hope Wright, Laura Webb, and Deborah Edmonds alleged that from 2013 to 2017, Saber Healthcare Group LLC improperly pressured therapists to provide Ultra High levels of rehabilitation therapy for all patients regardless of individual patient needs.  Ultra High levels of therapy involve a minimum of 720 minutes of therapy from two therapy disciplines, and are reimbursed at the highest rate possible by Medicare.  To enforce their illegal standard, Saber prevented therapists from providing lower levels of therapy, caused therapists to falsely report time, and pressured facility directors in daily or weekly calls.  As part of the settlement, Saber has agreed to a five year Corporate Integrity Agreement, and Wright, Webb, and Edmonds will receive $1.75 million of the settlement proceeds.  DOJ

April 14, 2020

Importer Blue Furniture Solutions, LLC, its successor XMillennium, LLC, and former executives Yingqing Zeng and Alex Cheng have agreed to pay more than $5.2 million to settle allegations that they violated the False Claims Act in conspiring to evade customs duties and fees on furniture imported from China.  In a qui tam complaint by whistleblower University Loft Company, which the United States elected to intervene in, the defendants were accused of declaring wooden bedroom furniture as “metal” or “non-bedroom”, manipulating packing lists and invoices, and directing manufacturers to mislabel boxes and falsify invoices to help defendants evade U.S. customs officials.  USAO WDTX

April 10, 2020

To settle fraud allegations by four relators in three qui tam suits, Michigan-based Encore Rehabilitation Services LLC has agreed to pay $4 million to the United States.  According to Linda Anderson, Reza Saffarian and Audrey Theile, and Adam LaFerriere, from roughly 2010 to 2018, the owner and operator of over 600 healthcare facilities allegedly caused three of its skilled nursing facilities to submit false claims to Medicare for services that were not medically necessary, reasonable, or provided by skilled therapists, and improperly billed group therapy sessions as if they were individual therapy sessions.  DOJ; USAO EDMI; USAO WDMI

April 8, 2020

The last defendant in a conspiracy to rig bids and fix prices for supply fuel to U.S. military bases in South Korea has agreed to pay $2 million to resolve civil claims under Section 4A of the Clayton Act and the False Claims Act.  The government’s investigation into all defendants, including Jier Shin Korea Co. Ltd. and its president, Sang Joo Lee, were instigated by a whistleblower and resulted in a previous settlement of over $205 million.  As part of the settlement, Jier Shin and Lee have agreed to cooperate in the ongoing investigation and abide by an antitrust compliance program.  DOJ

April 6, 2020

Following a $7.1 million settlement with seven co-defendants in October 2019, a chiropractor in New Jersey who allegedly concocted the scheme to bill Medicare for medically unnecessary injections and knee braces has agreed to pay $2 million to resolve his liability.  A critical analysis of Medicare claims data revealed that while treating for osteoarthritis, David Podell caused his clinic and seven Osteo Relief Institutes to bill Medicare for viscosupplementation injections—gel-like fluids injected into the knee that act as lubricant—as well as custom knee braces for beneficiaries who did not need them.  Additionally, the claims for the custom knee braces were tainted by illegal kickbacks that Podell solicited and received from the manufacturer.  DOJ; USAO MN

April 6, 2020

Georgia-based MiMedx Group Inc. has agreed to pay $6.5 million to settle allegations of defrauding the Department of Veterans’ Affairs by knowingly submitting false commercial pricing disclosures, in violation of the False Claims Act.  According to a qui tam complaint by whistleblowers Jess Kruchoski and Luke Tornquist, the false pricing disclosures enabled MiMedx to charge inflated prices for human tissue graft products.  Kruchoski and Tornquist will receive a relator’s share of $1,625,000.  DOJ; USAO MN
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