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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.

				

			

			
						
					
			

	
		
		

			

				
				
January 5, 2024

				 A Florida man, Karel Felipe, and Florida woman, Tamara Quicutis, have been sentenced to 8 years and 5 years respectively for their roles in a $93 million fraud scheme against Medicare.  Felipe and Quicutis were found guilty last October of submitting claims on behalf of three Michigan-based home health companies, for services never rendered, using stolen patient information, and then laundering the proceeds through dozens of shell companies and hundreds of bank accounts.  Their fellow co-conspirators—Jesus Trujillo, Didier Arcia, Alexey Gil, and Jeffrey Avila—have already been sentenced for their roles.  DOJ				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Home Health and Hospice, 
													  Medicare, 
													  Money Laundering, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 4, 2024

				 ChristianaCare has paid $42.5 million for violations of the federal False Claims Act and the Delaware False Claims and Reporting Act. In a qui tam whistleblower complaint filed in 2017, ChristianaCare's former chief compliance officer alleged illegal remuneration was provided to non-employee neonatologists and surgeons in the form of free or below fair market services by ancillary support providers, such as nurse practitioners, hospitalists, and physician assistants. These services were meant to induce referrals from the non-employees, creating a financial relationship. USAO DE				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  FCA State, 
													  Healthcare Fraud, 
													  Provider Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
January 4, 2024

				 Florida-based H. Lee Moffitt Cancer Center & Research Institute Hospital Inc. (Moffitt) has agreed to pay over $19.5 million to resolve allegations of violating federal and state False Claims Acts over a 6-year period.  A majority of the settlement proceeds, $18.2 million, will go to the federal government, while $1.3 million will go to the State of Florida.  The hospital allegedly billed the government for items and services that should have been billed to non-government sponsors.  DOJ				 					 

						
Tagged in:
													  FCA Federal, 
													  FCA State, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medicare, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
December 22, 2023

				 Cummins Inc. has agreed in principle to pay $1.675 billion—the largest ever Clear Air Act violation penalty—for installing defeat devices or undisclosed auxiliary emissions control devices on 960,000 RAM engines from 2014 through 2023. Defeat devices enable users to bypass, defeat, or render inoperative the onboard emissions controls required by the Clean Air Act, producing thousand of tons of excess omissions of nitrogen oxides, to which exposure over time can cause respiratory issues. DOJ				 					 

						
Tagged in:
													  Environmental Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
December 21, 2023

				 A Florida woman who submitted over $192 million in claims to Medicare for medically unnecessary and unprovided tests, equipment, and services, has been sentenced to 20 years in prison.  Elizabeth Hernandez ordered thousands of genetic testing and orthotic braces for patients she never spoke to or examined, ultimately ordering more cancer genetic tests than any other provider in the nation.  She also billed for thousands of telemedicine visits that she never performed, often billing for over 24 hours in a single day.  DOJ				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medical Devices and DME, 
													  Medicare, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
December 21, 2023

				 Ultragenyx Pharmaceutical, Inc., maker of Crysvita, will pay $6 million for violating the False Claims Act. Crysvita is prescribed to treat a rare inherited blood disorder, which may require a genetic test to definitively diagnose. To induce purchases and referrals, Ultragenyx paid a laboratory to conduct genetic tests at no cost to healthcare providers or patients, and then provide the results reports to Ultragenyx. Ultragenyx then used the positive test results reports to target healthcare providers for Crysvita sales. Internally, Ultragenyx referred to this kickback scheme as their "sponsored" testing program. The program was exposed via a qui tam whistleblower, who will receive $1.07 million of the $6.7 million recovery. DOJ				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Laboratory and IDTF, 
													  Medicaid, 
													  Medicare, 
													  Pharma Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
December 21, 2023

				 Armando Herrera was sentenced to 51 months in prison for distributing at least $16.7 million worth of adulterated and misbranded prescription HIV drugs. Herrera and his co-conspirators operated companies in four states, creating false documentation to then pass off the drugs as legitimately acquired, and then sold to unwitting pharmaceutical suppliers who, in turn, sold them to unsuspecting HIV patients. DOJ				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
December 19, 2023

				 Indiana-based Community Health Network Inc. has agreed to pay $345 million to resolve claims by its former CFO and COO Thomas Fischer, which alleged the healthcare system submitted claims to Medicare that were tainted by violations of the Stark Law.  In order to capture physicians’ downstream referrals, Community paid physicians salaries that were sometimes double market rate, and awarded them bonuses based on the number of referrals.  Community then submitted claims resulting from these referrals for reimbursement.  DOJ				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicare, 
													  Provider Fraud, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
December 18, 2023

				 Heart monitoring device manufacturer BioTelemetry Inc. and its subsidiary, LifeWatch Services Inc., have agreed to pay more than $14.7 million for causing false claims to be submitted to federal healthcare programs.  The claims were brought in two separate qui tam suits, one by an employee of one of LifeWatch’s customers, Michael Pelletier, and the other by SFP I LLC.  The whistleblowers alleged that the companies knew the design of their enrollment portal would steer clinical staff into enrolling patients in telemetry, which is reimbursed at a higher rate, rather than holter monitoring and event monitoring, which is reimbursed at a lower rate.  DOJ				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medical Devices and DME, 
													  Medicare, 
													  Other Government Health Programs, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
December 14, 2023

				 Freepoint Commodities LLC will pay more than $98 million in civil penalties and disgorgement for improperly obtaining and trading on material non-public information. Freepoint paid millions in bribes to government officials in Brazil to obtain highly confidential information related to the purchase and sale of fuel oil. Certain members of Freepoint's oil trading team knew of and took steps to conceal the fraud by using code words, fake names, and private email addresses, all to gain unlawful competitive advantages in oil products trading. DOJ; CFTC				 					 

						
Tagged in:
													  Bribery and Bid-Rigging, 
													  FCPA, 
													  Fraud in CFTC-Regulated Markets, 
													  Market Manipulation and Trading Violations, 
													  Misrepresentations, 
													  Regulatory Violations, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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