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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.

				

			

			
						
					
			

	
		
		

			

				
				
June 15, 2023

				 Two compounding pharmacies, Smart Pharmacy, Inc. and SP2, LLC, and their owner, Gregory Balotin, have agreed to pay at least $7.4 million to resolve two qui tam lawsuits by whistleblowers Amy Sanchez and Ashok Kohli, both former employees of Smart Pharmacy.  According to the suits, in order to increase orders for expensive compounded pain creams, the pharmacy routinely waived mandatory patient co-payments for them, and in order to boost reimbursements from Medicare and TRICARE, it added the antipsychotic drug aripiprazole to the topical creams.  DOJ				 					 

						
Tagged in:
													  Compounding Pharmacy Fraud, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicare, 
													  Other Government Health Programs, 
													  Whistleblower Case, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 8, 2023

				 Billy Joe Taylor of Lavaca, Arkansas, will spend 15 years in prison and will pay nearly $30 million in restitution for submitting false and fraudulent claims to Medicare. During the COVID-19 pandemic, Taylor and his co-conspirators misused medical information and private personal information for Medicare beneficiaries, and then used that information to repeatedly submit fraudulent claims for medically unnecessary diagnostic laboratory testing. USAO WDAR				 					 

						
Tagged in:
													  FCA Federal, 
													  Healthcare Fraud, 
													  Laboratory and IDTF, 
													  Lack of Medical Necessity, 
													  Medicare, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 8, 2023

				 Steven King, chief compliance officer of A1C Holdings LLC, a pharmacy holding company, was convicted for violating Medicare and pharmacy benefit manager rules by securing prescriptions and refills for medically unnecessary lidocaine and diabetic testing supplies. King and his co-conspirators fraudulently billed Medicare over $50 million, taking steps to conceal their scheme by enrolling their mail order pharmacies as brick-and-mortar retail locations, shipping prescription refills for high-reimbursing medications and supplies without patient consent, concealing the ownership of A1C Holdings LLC and its pharmacies, and transferring patients among pharmacies without patient consent. King faces a maximum penalty of 20 years in prison for committing health care fraud and wire fraud. DOJ				 					 

						
Tagged in:
													  Healthcare Fraud, 
													  Improper Medical Facility, 
													  Lack of Medical Necessity, 
													  Medicare, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 7, 2023

				 Anthony Merritt and Andrew De Moya have sentencing dates in October 2023 for bribing a former employee of the D.C. Office of Tax and Revenue to fraudulently remove millions in tax liabilities of businesses owned by De Moya, Arman Amirshahi, Charles Zhou, and others. Merritt acted as a middleman to facilitate the bribes and took a cut of the bribe payments as well. USAO DC				 					 

						
Tagged in:
													  Tax Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
June 5, 2023

				 Microsoft Corp. will pay $20 million in civil penalties for violating the Children’s Online Privacy Protection Act for allowing children under 13 to provide personal information—first and last name, email address, and their date of birth—when creating a user account for Microsoft’s Xbox system, without parental consent. Microsoft retained this data even when the account was not finalized, allowing Microsoft to send promotional messages and to share user data with advertisers. Microsoft failed to comply with COPPA’s notice provisions and will be required under the proposed order to clearly communicate with parents about their child’s data and follow set procedures to monitor Microsoft’s compliance with federal statutes regarding children’s online privacy. DOJ, FTC				 			
	
		
		
	


 			




	
		
		

			

				
				
May 31, 2023

				 VHS of Michigan Inc., d/b/a, The Detroit Medical Center, Vanguard Health Systems Inc., and Tenet Healthcare Corporation will pay nearly $30 million for causing the submission of false or fraudulent claims to Medicare. From January 1, 2014 through December 31, 2017, DMC, Vanguard, and Tenet violated the Anti-Kickback Statute when they provided the services of mid-level practitioners to 13 physicians at no cost or below fair market value. The physicians were selected for their high number of referrals, which DMC hoped would cause an increase in referrals to their facilities. Whistleblower Dr. Jay Meythaler will receive $5.2 million as part of the settlement. DOJ				 					 

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

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 25, 2023

				 Vascular surgeon Vasso Godiali of Michigan has been ordered to pay $19.5 million in restitution and serve over 6 years in prison to resolve criminal allegations of defrauding Medicare, Medicaid, and Blue Cross/Blue Shield of Michigan. Godiali also agreed to pay up to $43.4 million to resolve civil allegations of violating the False Claims Act.  Although Godiali allegedly began submitting false claims in 2009, his misconduct did not come to light until a 2015 qui tam suit by Innovative Solutions Consulting LLC, which alleged Godiali billed government programs for arterial thrombectomies and stent placements that were not medically necessary and not actually performed.  Additionally, Godiali allegedly falsified medical records to justify the procedures, and improperly used a modifier code to increase his reimbursements. DOJ				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Medicaid, 
													  Medical Billing Fraud, 
													  Medicare, 
													  Provider Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 17, 2023

				 BP Products North America Inc. entered a record-setting Clean Air Act Settlement with the DOJ and EPA, agreeing to reduce benzene, other hazardous air pollutants (HAP), and other volatile organic compounds emitted from their Whiting Refinery in Indiana. In addition to spending an estimated $197 million in capital investments to improve air quality surrounding the refinery, BPP will pay civil and stipulated penalties of $40 million, invest another $5 million in a supplemental environmental project to reduce diesel emissions in the surrounding communities, and install 10 air pollutant monitoring stations outside the refinery’s fencing. This is the largest stationary source settlement ever secured under the Clean Air Act. DOJ				 					 

						
Tagged in:
													  Environmental Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 16, 2023

				 Randall Judge Phelan, a former Tribal government official, will spend 5 years in prison for soliciting bribes and kickbacks from a contractor providing construction services on the Fort Berthold Indian Reservation in North Dakota, the home of the Mandan, Hidatsa, and Arikara Nation. For approximately 8 years, from 2013 to 2020, Phelan solicited and accepted bribes and kickbacks totaling more than $645,000. In exchange, Phelan helped the contractor’s business by awarding millions of dollars in contracts, fabricating bids, advocating for the contractor with other Tribal officials, and facilitating the submission and payment of fraudulent invoices. DOJ, USAO ND				 					 

						
Tagged in:
													  Bribery and Bid-Rigging, 
													  Government Procurement Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
May 11, 2023

				 GCI Communications Corp. has agreed to pay $40 million to resolve a whistleblower case by its former Director of Business Administration, which alleged the company violated the False Claims Act by failing to comply with competitive bidding regulations for the FCC’s Rural Health Care Program.  In order to participate in the program—which awards $570 million in subsidies annually to bring critical telecommunications services to rural healthcare providers—GCI was subject to regulations governing the prices it could charge these providers.  However, GCI charged inflated rates to a provider in Alaska, thereby receiving higher subsidy payments than it was entitled to.  For launching a successful enforcement action, whistleblower Robert Taylor will receive a $6.4 million share of the settlement.  DOJ				 					 

						
Tagged in:
													  FCA Federal, 
													  Government Procurement Fraud, 
													  Whistleblower Case, 
													  Whistleblower Rewards, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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