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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.

				

			

			
						
					
			

	
		
		

			

				
				
November 17, 2014

				 New York environmental remediation firm Sevenson Environmental Services Inc. agreed to pay more than $2.7M to resolve allegations it violated the False Claims Act and the Anti-Kickback Act by accepting kickbacks, rigging bids and passing inflated charges to the US Environmental Protection Agency (EPA) in connection with work performed at the Federal Creosote Superfund Site in Manville, New Jersey. According to the government, Sevenson solicited and accepted more than $1.6M in kickbacks from six companies in exchange for the award of subcontracts for work at the Federal Creosote Site. DOJ				 					 

						
Tagged in:
													  Bribery and Bid-Rigging, 
													  Environmental Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
November 14, 2014

				 Detroit-area physician Dr. Rajesh Doshi pleaded guilty for orchestrating — through his medical practice Home Physicians Services— the submission of fraudulent claims for physician home visits as part of a $19M home health care fraud scheme. According to his plea agreement, Dr. Doshi admitted that between October 2005 and September 2012, he conspired with others to commit health care fraud by referring Medicare beneficiaries for home health care that was not medically necessary, and then submitting false and fraudulent claims for the purported care to Medicare for reimbursement. Dr. Doshi also admitted he solicited and received kickbacks from home health agency owners in exchange for the referral of beneficiaries to those agencies, regardless of whether the beneficiaries qualified for or needed home health care. DOJ				 			
	
		
		
	


 			




	
		
		

			

				
				
November 13, 2014

				 A California federal court entered a permanent injunction against Scilabs Nutraceuticals Inc., and its board chairman and CEO Paul P. Edalat, to prevent the distribution of adulterated dietary supplements. SciLabs Nutraceuticals Inc. is a manufacturer of dietary supplements distributed under the brand name All Pro Science. DOJ				 			
	
		
		
	


 			




	
		
		

			

				
				
November 13, 2014

				 Five South Florida residents, Dennis Hernandez, Juan Valdes, Jose Alvarez, Joel San Pedro and Alina Hernandez, pleaded guilty to a long-running $6.2M Medicare fraud scheme involving Miami home health care agency Professional Medical Home Health LLC that purported to provide home health and therapy services. According to admissions in their plea agreements, the defendants through Professional Home Health billed Medicare for expensive physical therapy and home health services that were not medically necessary or were not provided. They also acted as patient recruiters for Professional Home Health soliciting and receiving kickbacks and bribes from other co-conspirators at Professional Home Health in exchange for recruiting beneficiaries who neither needed, nor in some cases received services. DOJ				 			
	
		
		
	


 			




	
		
		

			

				
				
November 13, 2014

				 Japanese auto parts maker Seiki Co. Ltd. agreed to plead guilty and pay a $35.8M million criminal fine for its role in a conspiracy to allocate customers of variable valve timing (VVT) devices sold to automobile manufacturers including General Motors Company, Nissan Motor Company Ltd., Volvo Car Corporation and BMW AG in the US and elsewhere.DOJ				 			
	
		
		
	


 			




	
		
		

			

				
				
November 13, 2014

				 Ramon Regueira, owner of Miami home health care company Nation’s Best Care Home Health Corp., pleaded guilty for his role in a $30M home health Medicare fraud scheme. Regueira admitted that he and his co-conspirators operated Nation’s Best for the purpose of billing the Medicare program for expensive physical therapy and home health care services not medically necessary or provided. Specifically, Regueira admitted he and his co-conspirators paid kickbacks and bribes to patient recruiters who provided patients to Nation’s Best, as well as prescriptions, plans of care (POCs) and certifications for medically unnecessary therapy and home health services. From January 2007 through November 2012, Nation’s Best submitted approximately $35M in false claims and Medicare paid approximately $21M for these fraudulent claims. DOJ				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Home Health and Hospice, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
November 12, 2014

				 Home healthcare agency CareAll Management LLC agreed to pay $25M to settle charges it violated the False Claims Act by submitting false and upcoded home healthcare billings to Medicare and Medicaid. According to the government, between 2006 and 2013, CareAll overstated the severity of patients’ conditions to increase billings and billed for services that were not medically necessary and rendered to patients who were not homebound. The current allegations first arose in a whistleblower lawsuit filed by Toney Gonzales under the qui tam provisions of the False Claims Act.  Gonzales will receive a whistleblower award in an undisclosed amount.  Whistleblower Insider				 					 

						
Tagged in:
													  FCA Federal, 
													  Home Health and Hospice, 
													  Lack of Medical Necessity, 
													  Upcoding, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
November 7, 2014

				 Flakeboard America Limited (and its parent companies Celulosa Arauco y Constitución S.A. and Inversiones Angelini y Compañía Limitada) and SierraPine agreed to pay a combined $3.8M in civil penalties and disgorge an additional $1.15M in illegally obtained profits for violating the Hart–Scott–Rodino (HSR) Act by engaging in illegal premerger coordination while Flakeboard’s proposed acquisition of three SierraPine mills was under DOJ antitrust review. Flakeboard and SierraPine abandoned the proposed acquisition after the DOJ expressed concerns about the transaction’s likely anticompetitive effects in the production of medium-density fiberboard, a wood product widely used in furniture, kitchen cabinets, and decorative mouldings. According to the government, SierraPine operated particleboard mills that competed directly with one of Flakeboard’s particleboard mills and before the expiration of the HSR Act’s mandatory premerger waiting period, Flakeboard, Arauco, and SierraPine illegally coordinated to close one of SierraPine’s mills and move the customers to Flakeboard. DOJ				 			
	
		
		
	


 			




	
		
		

			

				
				
November 6, 2014

				 Medical device maker Biotronik Inc. agreed to pay $4.9M to resolve allegations it violated the False Claims Act by paying kickbacks to induce physicians to use its products. Specifically, the government charged that Biotronik induced electrophysiologists and cardiologists practicing in Nevada and Arizona to use Biotronik pacemakers, defibrillators and cardiac resynchronization therapy devices by paying them in the form of repeated meals at expensive restaurants and inflated payments for membership on a physician advisory board. The allegations first arose in a whistleblower lawsuit filed by a former Biotronik employee, Brian Sant, under the qui tam provisions of the False Claims Act. Sant will receive a whistleblower award of $840,000. DOJ				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  FCA Federal, 
													  Medical Devices and DME, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
November 5, 2014

				 Elsa Ruiz, the owner and administrator of the Miami home health care companies Professional Home Care Solutions Inc. and LTC Professional Consultants Inc., was sentenced to serve 80 months in prison and pay $45M in restitution for her participation in a $74M Medicare fraud scheme. According to admissions during her plea hearing, Ruiz and her co-conspirators operated LTC and Professional Home Care for the purpose of billing the Medicare program for expensive physical therapy and home health care services that were not medically necessary or were not provided. Ruiz’s primary role in the scheme was to negotiate and pay kickbacks to patient recruiters and to otherwise oversee the schemes. DOJ				 			
	
		
		
	


 			


											

						

								

									
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