Month: September 2024

Source: United States Department of Justice Criminal Division

Acadia Healthcare Company Inc., a Delaware corporation with its principal place of business in Franklin, Tennessee, has agreed to resolve allegations that it violated the False Claims Act and related state statutes by knowingly billing for medically unnecessary inpatient behavioral health services or for services that did not meet federal and state regulations. Acadia Healthcare Company owns and operates inpatient behavioral health facilities throughout the United States, including The Pavilion at HealthPark LLC, doing business as Park Royal Hospital in Ft. Myers, Florida; Riverwoods Behavioral Health LLC, doing business as Lakeview Behavioral Health in Norcross, Georgia, and as Riverwoods Behavioral Health System in Riverdale, Georgia; Ten Broeck Tampa LLC, doing business as North Tampa Behavioral Health in Wesley Chapel, Florida; PHC of Michigan LLC, doing business as Harbor Oaks Hospital in New Baltimore, Michigan; and Seven Hills Hospital LLC, doing business as Seven Hills Hospital in Henderson, Nevada (collectively, Acadia).

The United States contended that, between 2014 and 2017, Acadia knowingly submitted false claims for payment to Medicare, Medicaid and TRICARE for inpatient behavioral health services that were not reasonable or medically necessary. In particular, the United States contended that Acadia admitted beneficiaries who were not eligible for inpatient treatment and failed to properly discharge beneficiaries when they no longer needed inpatient treatment and had improper and excessive lengths of stay. The United States further alleged that Acadia knowingly failed to provide adequate staffing, training and/or supervision of staff, which resulted in assaults, elopements, suicides and other harm resulting from these staffing failures. In addition, Acadia allegedly failed to provide inpatient acute care in accord with federal and state regulations, including, but not limited to, by failing to provide active treatment, to develop and/or update individualized assessments and treatment plans, to provide adequate discharge planning and to provide required individual and group therapy.

Under the settlement agreement, Acadia will pay $16,663,918 to the United States to resolve its liability under the False Claims Act for its allegedly false Medicare, Medicaid and TRICARE billings. The Medicaid program is jointly funded by the states and the federal government, and pursuant to separate settlement agreements, Acadia will pay an additional $3,186,082 to Florida, Georgia, Michigan and Nevada to resolve their state law claims against Acadia.  

“This settlement demonstrates the Justice Department’s commitment to ensuring that federal healthcare programs pay only for services that are needed and properly provided,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “It is particularly important that health care providers satisfy these requirements when providing services to a vulnerable patient population, such as residents of an inpatient behavioral health facility.”

“Federal health care programs rely upon the honesty and credibility of participating providers,” said U.S. Attorney Roger B. Handberg for the Middle District of Florida. “The Justice Department will hold accountable those who seek to exploit these programs for personal gain, jeopardizing the health of patients.”

“Medical providers who participate in federally funded health care programs must follow the law when billing Medicare, Medicaid and Tricare,” said Special Agent in Charge Tamala E. Miles of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “This settlement illustrates HHS-OIG’s commitment to protecting the integrity of these taxpayer-funded programs and the well-being of enrollees seeking treatment. Working closely with the United States Attorney’s Office and other law enforcement partners, we will continue to thoroughly investigate such fraudulent billing schemes.”

“Billing TRICARE for medically unnecessary inpatient behavioral health services or for services that did not meet federal and state regulations impacts our ability to reimburse providers in a timely manner for care that is needed to keep our military ready to defend the nation,” said Rear Admiral Matthew Case of the U.S. Navy and Acting Assistant Director for Health Care Administration for the Defense Health Agency. “We thank our state and federal partners for their work on this case, and the whistleblowers who came forward for their bravery. As a result, we are able to continue delivering one of the most comprehensive and affordable health benefits available to any American.”

The settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Franka Tirado, Brian Snyder and Jamie Thompson, all former employees of Acadia. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The qui tam cases are captioned U.S. ex rel. Tirado, et al. v. Park Royal Hospital et al., Case No. 2:17-cv-201-FtM-99 (MDFL), and U.S. ex rel. Thompson v. Acadia Healthcare Company Inc., et al., Case No. 2:18-cv-543-FtM-38CM (MDFL). The whistleblower share of the federal portion of the settlement will be $3,166,144.42.

The resolution obtained in this matter was the result of a coordinated effort between the Civil Division’s Commercial Litigation Branch, Fraud Section, and U.S. Attorney’s Office for the Middle District of Florida, as well as the National Association of Medicaid Fraud Control Units, with assistance from HHS-OIG and the Department of Defense Criminal Investigative Service.

The investigation and resolution of this matter illustrates the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement can be reported to HHS at 800-HHS-TIPS (800-447-8477).

Senior Trial Counsel Sarah Arni of the Civil Division’s Fraud Section and former Senior Litigation Counsel Lindsay Griffin for the Middle District of Florida handled the matter.

The claims resolved by the settlements are allegations only. There has been no determination of liability.

Settlement

Source: United States Department of Justice Criminal Division

The Justice Department today announced actions coordinated with the Department of State, Department of the Treasury, and other federal and international law enforcement partners to combat Russian money laundering operations. The actions involved the unsealing of an indictment charging a Russian national with his involvement in operating multiple money laundering services that catered to cybercriminals, as well as the seizure of websites associated with three illicit cryptocurrency exchanges.

“Today’s actions highlight the Department’s continued disruption of malicious cyber actors and their criminal ecosystem,” said Deputy Attorney General Lisa Monaco. “The two Russian nationals charged today allegedly pocketed millions of dollars from prolific money laundering and fueled a network of cyber criminals around the world, with Ivanov allegedly facilitating darknet drug traffickers and ransomware operators. Working with our Dutch partners, we shut down Cryptex, an illicit crypto exchange and recovered millions of dollars in cryptocurrency.”

“Every step cybercriminals take in their pursuit of money leaves another track that leads us to their doorstep,” said U.S. Attorney Jessica D. Aber for the Eastern District of Virginia. “And if you follow them on their path of greed, they will lead us to you. We will not stop, because while domains can always be seized, justice is unyielding.”

“The Secret Service is relentless in pursuing those engaged in criminal activity,” said Assistant Director Brian Lambert of the U.S. Secret Service. “I thank our domestic and foreign partners for their efforts on this case, as we continue our work bringing to justice those engaged in transnational criminal activity.”

According to court documents unsealed today in the Eastern District of Virginia, Russian national Sergey Ivanov, known online as “Taleon,” among other aliases, was charged with one count of conspiracy to commit and aid and abet bank fraud for providing payment processing support to the carding website Rescator, and one count of conspiracy to commit money laundering for laundering proceeds from the carding website Joker’s Stash. “Carding” is the unlawful acquisition of and trade in stolen credit and debit card information for fraudulent purposes. Ivanov allegedly operated for nearly two decades as a professional cyber money launderer, advertising his services to other cybercriminals on exclusive Russian-speaking criminal forums. Over the years, Ivanov’s laundering services and payment systems have catered to cybercrime marketplaces, ransomware groups, and hackers responsible for significant data breaches of major U.S. companies.

Ivanov allegedly created and/or operated Russian payment and exchange services UAPS, PinPays, and PM2BTC, which provided money transfer and laundering services directly to criminals. Cryptocurrency blockchain analysis revealed that between July 12, 2013, and Aug. 10, cryptocurrency addresses associated with Ivanov’s alleged money laundering services conducted transactions totaling approximately $1.15 billion in value. Approximately 32% of all traced bitcoin sent to these addresses originated from other cryptocurrency addresses associated with criminal activity. For example, more than $158 million of bitcoin flowing into Ivanov’s addresses allegedly represented fraud proceeds, more than $8.8 million allegedly represented proceeds from known ransomware payments, and approximately $4.7 million allegedly originated from darknet drug markets. The U.S. Secret Service has obtained court authorization to seize domains associated with the UAPS and PM2BTC websites.

The Rescator carding website allegedly sold stolen payment card data from U.S. financial institutions and personally identifiable information (PII) of U.S. citizens. For example, the website allegedly advertised the sale of data from up to 40 million payment cards and the PII of approximately 70 million people that had been stolen from a major U.S. retail victim in 2013. The breach cost the U.S. retail victim at least $202 million in expenses and caused damage to the U.S. retail victim’s customers, who became targets of identity theft by other cybercriminals. Ivanov allegedly provided payment processing support for the Rescator carding site through the UAPS and PinPays services for purchases made on the site using bitcoin.

Additionally, Russian national Timur Shakhmametov, known online as “JokerStash” and “Vega,” among other aliases, is charged in the same indictment with one count of conspiracy to commit and aid and abet bank fraud, one count of conspiracy to commit access device fraud, and one count of conspiracy to commit money laundering related to his work in operating the carding website Joker’s Stash and laundering the proceeds. Joker’s Stash offered for sale data from approximately 40 million payment cards annually, totaling hundreds of millions of payment cards overall, and was one of the largest known carding markets in history. Estimates of its profits range from $280 million to more than $1 billion. Shakhmametov and others allegedly promoted Joker’s Stash and its products by advertising the Joker’s Stash website and its stolen payment card data on numerous online cybercrime forums.

Separately, the U.S. Secret Service executed a seizure order from the District of Maryland against two website domain names used to support the cryptocurrency money laundering exchange “Cryptex.net.” According to court records unsealed today, Cryptex.net and Cryptex.one were associated with the administration and operation of Cryptex, which offers complete anonymity to Cryptex users by allowing them to register for accounts without providing know-your-customer compliance requirements. Like UAPS and PM2BTC, Cryptex advertised itself directly to cybercriminals.

According to a company that provides blockchain analytics services to law enforcement, there have been more than 37,500 transactions involving bitcoin addresses associated with Cryptex, amounting to a total value of approximately 62,586 bitcoin, or $1.4 billion at the time the transactions were made. Of that amount, about 31% of the bitcoin sent, or $441 million, originated from cryptocurrency addresses associated with criminal conduct, including $297 million of fraud proceeds and more than $115 million of proceeds from ransomware payments. Nine percent of all bitcoin sent to Cryptex, or $162 million, originated from cryptocurrency addresses associated with services often used by cybercriminals. Further, 28% of all bitcoin sent from Cryptex was sent to companies or darknet markets sanctioned by the United States.

The seizure of these domains by the government will prevent the owners and third parties from using the sites for money laundering. Individuals visiting those sites now will see a message indicating that the site has been seized by the federal government.

As part of the coordinated actions taken today, our Dutch partners seized the servers hosting PM2BTC and Cryptex. Those servers have been taken offline at various locations around the world, and the Dutch have seized cryptocurrency from those servers worth over $7 million.

In coordination with the department’s actions, other U.S. government agencies and foreign law enforcement partners are also taking related actions. The U.S. Department of State issued reward offers up to $11 million through its Transnational Organized Crime Rewards Program for information leading to the arrest and/or conviction of Ivanov and others involved in the operation of his money laundering services, and for Shakhmametov and others involved in the operation of Joker’s Stash. Treasury’s Financial Crimes Enforcement Network (FinCEN) issued an order that identifies PM2BTC as being of “primary money laundering concern” in connection with Russian illicit finance. Concurrently, Treasury’s Office of Foreign Assets Control (OFAC) sanctioned Cryptex and Ivanov.

The U.S. Secret Service Cyber Investigative Section is investigating the case.

Assistant U.S. Attorney Zoe Bedell for the Eastern District of Virginia is prosecuting the case against Ivanov and Shakhmametov. Trial Attorney Jeff Pearlman and Senior Counsel Jessica Peck of the Criminal Division’s Computer Crime and Intellectual Property Section and Assistant U.S. Attorney Thomas Sullivan of the District of Maryland are handling the investigation into Cryptex. The Justice Department’s Office of International Affairs also provided assistance in these matters.

The Netherlands Police, Dutch Fiscal Information and Investigation Service, the International Cooperation Department of the Central Criminal Police of the State Police of Latvia, Europol, the National Cyber-Forensics & Training Alliance, the German Federal Criminal Police Office, and the UK National Crime Agency provided invaluable assistance.

The text of FinCEN’s order can be found here.

For more information on the individuals and entities that OFAC designated today, click here.

Source: United States Department of Justice Criminal Division

The Justice Department today announced several actions to improve firearm background checks and reduce gun violence. The Department is releasing model legislation and information that would help states permit the sharing of juvenile criminal history and mental health records with the National Instant Criminal Background Check System (NICS), solely for the purpose of conducting firearm background checks. In addition, the Department is announcing significant new grant funding for gun violence prevention, totaling over $200 million. Finally, the Department is unveiling new resources for law enforcement across the country, including training and funding guidance.

“The Department of Justice is committed to doing everything in its power to combat gun violence and save lives,” said Attorney General Merrick B. Garland. “Today’s actions are a continuation of our efforts to fully implement the Bipartisan Safer Communities Act, to provide critical funding to community violence intervention programs, and to assist our state and local partners as they work day in and day out to drive down gun crime.”

Under the Bipartisan Safer Communities Act of 2022 (BSCA), NICS is required to contact state and local law enforcement entities to determine if a purchaser under 21 years of age is prohibited from purchasing a firearm. However, as part of established juvenile justice and mental health systems, some states and territories have important laws in place which restrict the sharing of juvenile mental health and/or criminal history records, so that youthful mistakes do not follow young people into adulthood.

At the same time, these protections may prevent jurisdictions from providing the FBI with potentially disqualifying juvenile records when an enhanced background check is conducted. The model legislation released today, following in the example of several states that have appropriately and narrowly amended their record-sharing laws, provides a template for states that wish to permit greater information-sharing with NICS for the sole purpose of responding to a federal enhanced background check, thereby advancing public safety. In addition, the Justice Department is also releasing today information on state laws around the country, including whether they permit information-sharing with regard to juvenile records for enhanced background checks.

Additionally, the Justice Department is also announcing two major rounds of grant funding designed to reduce and prevent gun violence. First, the Department is announcing an additional $85 million in funding through the Office of Justice Programs Community Violence Intervention and Prevention Initiative (CVIPI). This funding will help 30 agencies and organizations develop and expand their community violence intervention work, including hospital-based violence intervention, street outreach, and cognitive behavioral therapy, and will support training and technical assistance plus rigorous research to help grow the evidence base for violence intervention models. Second, the Department is announcing over $135 million in formula awards to 48 states under the Byrne State Crisis Intervention Program (Byrne SCIP), which provides funding for the implementation of extreme risk protection order programs, state crisis intervention court proceedings, and related programs/initiatives.

Moreover, the Justice Department is committed to supporting implementation of the recommendations from the Critical Incident Report (CIR) on the mass shooting at Robb Elementary School in Uvalde, Texas. These implementation efforts include a suite of resources to not only support the local community of Uvalde, but also to serve as a resource across the country, particularly for local, rural, and regional agencies serving their communities. Today, the Department’s Community Oriented Policing Services (COPS) office is releasing a Tenets of Training Checklist to assist law enforcement executives and training personnel in enhancing relevant training and a Resource Webpage tailored to the needs of Small and Rural agencies. This fall, DOJ will release a Self-Assessment Tool to help communities assess how well they are implementing the recommendations in the CIR and an Implementation and Resource Guide to identify resources and generally accepted practices and standards in the CIR. Additional resources will be released on a continual basis to continue to support law enforcement agencies and their communities.

The COPS Office Collaborative Reform Initiative Technical Assistance Center (CRI-TAC) is also launching a renewed focus on assisting small and rural law enforcement agencies. Small and rural agencies will continue to have access to the no-cost training and technical assistance that CRI-TAC is known for, but now CRI-TAC will provide training and technical assistance opportunities geared for the unique challenges confronting small and rural policing agencies. Through the Small and Rural Agency Initiative, agencies will be able to participate in training programs addressing areas such as active assailant response, multi-jurisdictional coordination, community partnerships, resource allocation, addressing hate crimes, report writing, duty to intervene, and crash re-construction.

Model Legislation to Remove Barriers to Completing Enhanced Background Checks (PDF)

States’ Legal Ability to Provide Juvenile Information

Source: United States Department of Justice Criminal Division

Note: View the findings report here.

Following a comprehensive investigation, the Justice Department announced today that the City of Lexington, Mississippi (City), and Lexington Police Department (LPD) engage in a pattern or practice of conduct that deprives people of their rights under the U.S. Constitution and federal law. Lexington is a town of approximately 1,200 people, located about an hour outside of Jackson, Mississippi.

Specifically, the Justice Department finds that LPD unlawfully

• Arrests, jails and detains people who cannot pay fines or fees, without assessing their ability to pay;
• Uses excessive force;
• Conducts stops, searches and arrests without probable cause, including jailing people on illegal “investigative holds” and arresting people solely because they owe outstanding fines;
• Imposes money bail without justification or assessment of ability to pay;
• Jails people without prompt access to court;
• Violates the rights of people engaged in free speech and expression, including by retaliating against people who criticize the police;
• Discriminates against Black people; and
• Operates under an unconstitutional conflict of interest because LPD’s funding depends on the money it raises through its enforcement.

“Today’s findings show that the Lexington Police Department abandoned its sacred position of trust in the community by routinely violating the constitutional rights of those it was sworn to protect,” said Attorney General Merrick B. Garland. “The Justice Department’s investigation uncovered that Lexington police officers have engaged in a pattern or practice of discriminating against the city’s Black residents, used excessive force, and retaliated against those who criticize them. Additionally, Lexington’s approach to fines and fees — including unlawfully arresting, jailing, and detaining people based on their failure to pay money without assessing if they can afford to do so — has been devastating for its residents. Being poor is not a crime, but practices like these amount to punishing people for poverty. People in that community deserve better, and the Justice Department is committed to working with them, the City, and the Police Department to make the City safer for all its citizens.”

“Public safety depends on public confidence in our justice system,” said Deputy Attorney General Lisa Monaco. “The Lexington Police Department’s incarceration of individuals because they could not afford to pay fines — as detailed in today’s findings report — undermined that confidence and violated the civil rights of Lexington residents. I’m grateful to the Civil Rights Division for its thorough investigation and continued work to address these findings.”

“Lexington is a small, rural community but its police department has had a heavy hand in people’s lives, wreaking havoc through use of excessive force, racially discriminatory policing, retaliation, and more. In every corner of our country, police officers must respect people’s constitutional rights and treat people with dignity,” said Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division. “After an extensive review, we found that police officers in Lexington routinely make illegal arrests, use brutal and unnecessary force, and punish people for their poverty — including by jailing people who cannot afford to pay fines or money bail. For too long, the Lexington Police Department has been playing by its own rules and operating with impunity — it’s time for this to end. Our findings report furthers the Justice Department’s commitment to ensuring fairness and the rule of law.”

“Police have the authority to enforce the law, not to act as debt collectors for the City, extracting payments from the poor with threats of jail,” said U.S. Attorney Todd Gee for the Southern District of Mississippi. “No matter how large or small, every police department has an obligation to follow the Constitution.”

Based on the department’s investigation, over the past two years, LPD has made nearly one arrest for every four people in town, primarily for low-level offenses and traffic violations. That is more than 10 times the per capita arrest rate for Mississippi as a whole. Many of these arrests were for non-criminal conduct, like owing outstanding fines and using profanity. Most of those arrested are Black people. In 2023, Black people were 17.6 times more likely to be arrested by LPD than white people were.

When making low-level arrests, LPD uses tactics normally reserved for serious offenses. For example, LPD officers broke down a Black man’s door to arrest him for swearing at a public official. In another case, while attempting to arrest a man for having a tinted windshield, officers followed the man’s car to his house, forced their way into his home, and tased him for 15 seconds. On the same day the Justice Department opened the investigation, LPD officers chased a man accused only of disturbing a business and tased him nine times.

LPD’s enforcement strategy has put hundreds of people in debt to the police department. In a town of about 1,200 people, the total sum of outstanding fines owed to LPD is more than $1.7 million.

The department also found that LPD lacks any meaningful accountability system and that people experiencing poverty who are accused of crimes in Lexington regularly lack access to counsel, both of which allow LPD’s misconduct to continue unchecked.

The Justice Department opened its investigation on Nov. 8, 2023. Career attorneys and staff in the Civil Rights Division’s Special Litigation Section and the U.S. Attorney’s Office for the Southern District of Mississippi conducted the investigation. The team was assisted in this investigation by experts in law enforcement practices. The team conducted an extensive review of LPD’s records, including hundreds of arrest reports and municipal court records and hundreds of hours of body-worn camera footage. The team also interviewed City and LPD leadership and line officers, accompanied officers on ride-alongs, observed the Lexington Municipal Court, and met with dozens of community members.

In February, while the investigation was ongoing, the department issued a letter to the City of Lexington raising significant concerns regarding their practice of jailing people for unpaid fines without first assessing whether they can afford to pay them.

The City and LPD cooperated fully with the investigation. The City and LPD have committed to working cooperatively with the department to address the violations identified in the department’s findings.

The department conducted this investigation pursuant to 34 U.S.C. § 12601 (Section 12601), which prohibits law enforcement officers from engaging in a pattern or practice of conduct that deprives people of rights protected by the Constitution or federal law. Section 12601 authorizes the Attorney General to file a lawsuit in federal court seeking court-ordered remedies to eliminate a pattern or practice of unlawful conduct.

This investigation reflects the Justice Department’s efforts to ensure constitutional policing and to combat unlawful practices with respect to fines and fees. The department previously addressed policing for profit in its findings on the Ferguson Police Department in Missouri in 2015. The consent decree that followed has resulted in the dismissal of about 63,000 citations and a reduction of over $1 million in fines and fees. In July 2022, the department filed a Statement of Interest in Coleman v. Brookside, explaining that judges, prosecutors, and police violate the Constitution when they are motivated by profit rather than justice. And in April 2023, the department issued a Dear Colleague Letter containing updated guidance on fines and fees for state and local courts.

The department will be conducting outreach to members of the Lexington community for input on remedies to address the department’s findings. Individuals may submit recommendations to Community.LexingtonMS@usdoj.gov.

The Justice Department will hold a public community meeting on Sept. 26 at 6:00 p.m. CT at St. Paul C.O.G.I.C. Fellowship Hall, 17214 Highway 17 South, Lexington, MS 39095. Members of the public are encouraged to attend.

Additional information about the Justice Department’s Civil Rights Division is available on its website at www.justice.gov/crt. Additional information about the U.S. Attorney’s Office for the Southern District of Mississippi is available at www.justice.gov/usao-sdms. Information specific to the Civil Rights Division’s Police Reform Work can be found at www.justice.gov/crt/file/922421/download.