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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.

August 11, 2022

Menswear company Luchiano Visconti Loutie LLC d/b/a Luchiano Visconti and its manager Sasha Hourizadeh will pay $3.64 million for violating the False Claims Act by underreporting the value of imported apparel, resulting in over $1.8 million in evaded customs duties. Visconti and Hourizadeh regularly provided falsified invoices to customs brokers that significantly understated the true value of the imported menswear. In some instances, a complicit foreign manufacturer would provide Visconti two sets of invoices—one reflecting itemized pricing details at a reduction, and the second reflecting “services” provided which, when combined, reflected the actual value of the goods. A related whistleblower suit was filed prior to the Government joining the matter. USAO SDNY

August 11, 2022

Spivack, Inc., formerly operating as Verree Pharmacy, and owner-pharmacist Mitchell Spivack, have agreed to pay over $4.1 million in civil penalties for dispensing opioids despite numerous red flags the drugs were being diverted—all in violation of the False Claims Act and the Controlled Substances Act. In furtherance of the fraud, Spivack made false statements to drug distributors to maintain the façade of legitimacy, while concurrently drawing millions from the pharmacy and harming the public. In addition to their opioid fraud, Spivack and Verree effectuated their “Bill But Don’t Fill” scheme, where they would enter “BBDF” in their internal computer system, and would submit false claims to insurers for drugs not actually dispensed. USAO EDPA

August 11, 2022

Industrial battery maker Eos Energy Storage LLC will pay $1.02 million, after a whistleblower filed suit alleging violations of the False Claims Act. From mid-2018 to mid-2019, Eos failed to declare the value of certain components shipped overseas to be assembled and then imported back into the United States. Eos also failed to declare transportation and packing costs on more than 60 occasions, which Eos further acknowledged was their responsibility as importer of record. The whistleblower will receive 20% of the settlement amount. USAO NJ

August 10, 2022

Melissa Lynne Horner, co-owner of H & H Earthworks, Inc., will spend 30 months in prison and pay over $2.8 million in restitution for failing to pay employee and employer taxes to the IRS, as well as Earthworks’ portion of the FICA taxes. Rather than paying taxes, Horner used the money for her personal gain, spending over $100,000 on motor sport vehicles, $90,000 to a real estate title company, and at least $50,000 on home renovations and $20,000 for a motorhome. USAO MT

August 10, 2022

Thomas Valdez Rodriguez will spend 24 months in prison and will pay over $12.7 million in restitution to the IRS. As owner of Tom-E-Lee Trucking and Tom-E-Lee Industries, Rodriguez failed to withhold employment taxes from his employees. In addition to his failures to meet his businesses’ tax obligations, Rodriguez has not paid personal income taxes since 2011. Rather than paying his taxes, Rodriguez lived extravagantly and enjoyed flying his friends on private jets to Dallas Cowboys games, where Rodriguez was a season ticket holder on the 50-yard line. All told, the harm to the government equated $12,714,214.42, of which Rodriguez paid $1 million immediately prior to his sentencing. USAO WDTX

August 10, 2022

American Senior Communities, L.L.C., will pay over $5.5 million for violating the False Claims Act by charging Medicare directly for hospice services that should have already been covered by the beneficiaries’ Medicare hospice coverage. The fraudulent billing practice was exposed in a whistleblower complaint filed by a former employee of a hospice services provider that worked with ASC. The whistleblower is entitled to receive between 15 and 25% of the recovery. USAO SDIN

August 5, 2022

Gonzaga Interventional Pain Management, Melvin Gonzaga, M.D., and his son Rommel Gonzaga will pay $980,000 for violating the False Claims Act by submitting claims for medically unnecessary urine drug tests. GIPM required patients to submit a UDT sample before being seen by a provider and discussing the results from any prior UDT the patient received. Regardless of the patients’ individualized testing needs, GIPM always opted for the more complex “definitive” UDT rather than the lower-level “presumptive” UDT, netting a higher reimbursement rate from the US government. USAO MD

August 4, 2022

Eastern Iowa Dermatology, PLC and Dr. Manish Kumar will pay $1.66 million for violating the False Claims Act. Defendants submitted up-coded claims to Medicare for office visits and destruction or removal of skin tags and lesions, the sole purpose of which is to increase Medicare’s reimbursement rate. In addition to the monetary penalty, they agreed to an Integrity Agreement and are subject to ongoing monitoring by the US DHHS. USAO SDIA

August 3, 2022

North Country Neurology, P.C. will pay $850,000 for violating the False Claims Act by submitting claims falsely listing a physician as the service provider, when the services were provided instead by an unsupervised non-physician practitioner. Medicare will reimburse for certain services provided by NPPs, but require a physician to be physically present in the office and immediately available to furnish assistance. This was not the case on over 120 occasions, and NCN admitted it should have known it was improper to bill at the higher physician rather than NPP level. Additionally, NCN improperly billed Medicare on approximately 761 occasions for Botox, even though it had already been paid for by another insurer. NCN blamed their insufficient compliance program for the errors. USAO NDNY

August 3, 2022

Arthur Merson will spend 15 months in prison and will pay over $3.4 million in restitution for his scheme to defraud investors by conspiring to commit wire fraud. Merson acted as an intermediary between investors and the principal co-conspirators, representing to investors they could receive a portion of the value of multi-million-dollar Standby Letters of Credit with a minimal investment, and would reap multiples of their investment in a matter of weeks. In 2017 and 2018, Merson lied to investors, calling himself an independent consultant who would receive only a small finder’s fee for his efforts, when in reality he had significant financial interest in the investments and affirmatively misled investors when responding to their inquiries. USAO ME
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