Author: MIL-OSI Publisher

Source: United States Department of Justice Criminal Division

BioReference Health LLC, formerly known as BioReference Laboratories Inc. (BioReference) and OPKO Health Inc. (OPKO), have agreed to pay $704,349 to resolve alleged violations of the False Claims Act arising from BioReference’s submission of claims for laboratory tests that had not been ordered by a patient’s provider. OPKO is a Delaware Corporation. BioReference, a subsidiary of OPKO, is headquartered in New Jersey and is one of the largest clinical laboratories in the United States.

The United States alleged that BioReference and OPKO knowingly submitted false claims to federal healthcare programs for complete blood count (CBC) with automated white blood cell (WBC) differential laboratory tests that were not medically necessary. Specifically, the United States alleged that, from Jan. 1, 2012, until March 1, 2023, BioReference and OPKO routinely performed more expensive CBC with WBC differential tests when, in fact, medical providers had ordered less expensive CBC with no WBC differential tests, and then billed federal healthcare programs for the more expensive and medically unnecessary tests.

“Health care providers are expected to provide and bill only for services that are medically necessary,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “Today’s settlement demonstrates our commitment to protecting the integrity of federal health care programs and the taxpayer funds that support them.”

“BioReference allegedly profited by fraudulently performing and billing the federal government for unreasonable and unnecessary lab tests,” said U.S. Attorney David C. Weiss for the District of Delaware. “Schemes like these waste taxpayer money and raise healthcare costs for all Americans. My office will vigorously enforce anti-fraud statutes like the False Claims Act to combat such fraud and abuse of our healthcare system.”

“Laboratory companies have a responsibility to perform the specific testing requested by physicians’ orders,” said Special Agent in Charge Maureen R. Dixon of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG is committed to working with the Justice Department to investigate allegations of inappropriate insurance claims and to safeguard the integrity of our federal health care programs.”

The settlement stems from allegations originally brought in a lawsuit filed in the District of Delaware by a whistleblower under the qui tam provisions of the False Claims Act, which allow private parties, known as relators, to bring suit on behalf of the government and to share in any recovery. In connection with today’s announced settlement, the relator will receive $112,694 of the recovery. The qui tam case is captioned United States ex rel. Omni Healthcare Inc. v. OPKO Health, Inc. and BioReference Laboratories Inc., Civil Action No. 19-1670 (DDE).

This settlement 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 District of Delaware with assistance from HHS-OIG. Trial Attorney Claire L. Norsetter of the Justice Department’s Civil Division and Assistant U.S. Attorney Shamoor Anis for the District of Delaware handled the matter.

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

Settlement

Source: United States Department of Justice Criminal Division

The Justice Department issued the following statements from Attorney General Merrick B. Garland and Deputy Attorney General Lisa Monaco on the Supreme Court’s decision in TikTok, et al. v. Garland:

“The Court’s decision enables the Justice Department to prevent the Chinese government from weaponizing TikTok to undermine America’s national security,” said Attorney General Garland. “Authoritarian regimes should not have unfettered access to millions of Americans’ sensitive data. The Court’s decision affirms that this Act protects the national security of the United States in a manner that is consistent with the Constitution.”

“We welcome today’s decision by the Supreme Court. The Justice Department has long warned about the national security harms from PRC control of TikTok — including the ability to gather sensitive information about tens of millions of Americans and to covertly manipulate the content delivered to them,” said Deputy Attorney General Lisa Monaco. “The Court’s ruling also underscores that the bipartisan legislation upheld today is focused on protecting Americans, not restricting free speech. Rather, this legislation is about breaking the ties that bind TikTok to the government in Beijing, in a manner consistent with the Constitution. The next phase of this effort — implementing and ensuring compliance with the law after it goes into effect on January 19 — will be a process that plays out over time.”

Source: United States Department of Justice 2

BioReference Health LLC, formerly known as BioReference Laboratories Inc. (BioReference) and OPKO Health Inc. (OPKO), have agreed to pay $704,349 to resolve alleged violations of the False Claims Act arising from BioReference’s submission of claims for laboratory tests that had not been ordered by a patient’s provider. OPKO is a Delaware Corporation. BioReference, a subsidiary of OPKO, is headquartered in New Jersey and is one of the largest clinical laboratories in the United States.

The United States alleged that BioReference and OPKO knowingly submitted false claims to federal healthcare programs for complete blood count (CBC) with automated white blood cell (WBC) differential laboratory tests that were not medically necessary. Specifically, the United States alleged that, from Jan. 1, 2012, until March 1, 2023, BioReference and OPKO routinely performed more expensive CBC with WBC differential tests when, in fact, medical providers had ordered less expensive CBC with no WBC differential tests, and then billed federal healthcare programs for the more expensive and medically unnecessary tests.

“Health care providers are expected to provide and bill only for services that are medically necessary,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “Today’s settlement demonstrates our commitment to protecting the integrity of federal health care programs and the taxpayer funds that support them.”

“BioReference allegedly profited by fraudulently performing and billing the federal government for unreasonable and unnecessary lab tests,” said U.S. Attorney David C. Weiss for the District of Delaware. “Schemes like these waste taxpayer money and raise healthcare costs for all Americans. My office will vigorously enforce anti-fraud statutes like the False Claims Act to combat such fraud and abuse of our healthcare system.”

“Laboratory companies have a responsibility to perform the specific testing requested by physicians’ orders,” said Special Agent in Charge Maureen R. Dixon of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG is committed to working with the Justice Department to investigate allegations of inappropriate insurance claims and to safeguard the integrity of our federal health care programs.”

The settlement stems from allegations originally brought in a lawsuit filed in the District of Delaware by a whistleblower under the qui tam provisions of the False Claims Act, which allow private parties, known as relators, to bring suit on behalf of the government and to share in any recovery. In connection with today’s announced settlement, the relator will receive $112,694 of the recovery. The qui tam case is captioned United States ex rel. Omni Healthcare Inc. v. OPKO Health, Inc. and BioReference Laboratories Inc., Civil Action No. 19-1670 (DDE).

This settlement 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 District of Delaware with assistance from HHS-OIG. Trial Attorney Claire L. Norsetter of the Justice Department’s Civil Division and Assistant U.S. Attorney Shamoor Anis for the District of Delaware handled the matter.

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

Settlement

Source: United States Department of Justice 2

The Justice Department issued the following statements from Attorney General Merrick B. Garland and Deputy Attorney General Lisa Monaco on the Supreme Court’s decision in TikTok, et al. v. Garland:

“The Court’s decision enables the Justice Department to prevent the Chinese government from weaponizing TikTok to undermine America’s national security,” said Attorney General Garland. “Authoritarian regimes should not have unfettered access to millions of Americans’ sensitive data. The Court’s decision affirms that this Act protects the national security of the United States in a manner that is consistent with the Constitution.”

“We welcome today’s decision by the Supreme Court. The Justice Department has long warned about the national security harms from PRC control of TikTok — including the ability to gather sensitive information about tens of millions of Americans and to covertly manipulate the content delivered to them,” said Deputy Attorney General Lisa Monaco. “The Court’s ruling also underscores that the bipartisan legislation upheld today is focused on protecting Americans, not restricting free speech. Rather, this legislation is about breaking the ties that bind TikTok to the government in Beijing, in a manner consistent with the Constitution. The next phase of this effort — implementing and ensuring compliance with the law after it goes into effect on January 19 — will be a process that plays out over time.”

Source: United States Department of Justice

The Justice Department filed a civil injunction suit yesterday in federal court in Fort Lauderdale, Florida. The suit seeks to bar a Broward County, Florida, tax return preparer and his business from owning or operating a tax return preparation business and preparing tax returns for others.

The complaint alleges that Suni Ramchandani and his business SR Chandra Inc., doing business as AHS Income Tax Service, prepare federal tax returns for customers on which the preparers claim fraudulent deductions and credits to purposely underreport the tax their customers owe and claim refunds their clients are not entitled to receive. Specifically, the complaint alleges that Ramchandani and AHS prepare returns with false or inflated deductions, business expenses and business losses, as well as false claims for residential energy credits, fuel tax credits and other credits. The complaint also alleges that Ramchandani and AHS file returns that include a Form 8888 (Allocation of Refund), diverting customers’ additional refund amounts to bank accounts associated with Ramchandani without their customers’ knowledge or consent.

The government further alleges that Ramchandani and AHS prepare thousands of tax returns each year, and that when the IRS examined dozens of returns for 2022 and 2023, between 78-82% of the examined returns had errors and fabrications. According to the complaint, the repeated understatement of tax has harmed the United States by causing a revenue loss of approximately $11 million over the past two years. In addition to seeking an injunction against Ramchandani and AHS, the government has requested an order of disgorgement to prevent them from profiting from their violation of the internal revenue laws.

Deputy Assistant Attorney General David A. Hubbert of the Justice Department’s Tax Division made the announcement.

Taxpayers seeking a return preparer should remain vigilant against unscrupulous tax preparers. The IRS has information on its website for choosing a tax return preparer and has launched a free directory of federal tax preparers. The IRS also offers guidance on the credentials and qualifications that taxpayers should seek from their return preparer.

In addition, IRS Free File, a public-private partnership, offers free online tax preparation and filing options on IRS partner websites for individuals whose adjusted gross income is under $79,000. For individuals whose income is over that threshold, IRS Free File offers electronic federal tax forms that can be filled out and filed online for free.

In the past decade, the Tax Division has obtained injunctions against hundreds of unscrupulous tax preparers. Information about these cases is available on the Justice Department’s website. An alphabetical listing of persons enjoined from preparing returns and promoting tax schemes can be found this page. If you believe that one of the enjoined persons or businesses may be violating an injunction, please contact the Tax Division with details.