Attorney General Merrick B. Garland issued the following statement today, commemorating the 27th anniversary of the Oklahoma City Bombing, which took place April 19, 1995, in Oklahoma City, Oklahoma:
“Every year on this day, we remember those who were killed when a domestic terrorist bombed the Alfred P. Murrah Federal Building in Oklahoma City, taking the lives of 168 people, including 19 children, and seriously injuring hundreds of others.
“And every year on this day, we commemorate the strength of the Oklahoma City community that came together in the face of that loss.
“The Justice Department apprehended, prosecuted, and convicted the men responsible for the bombing of the Murrah Federal Building. As we did, we never forgot the victims, in whose memories we worked.
“Twenty-seven years later, the Justice Department remains vigilant in the face of the threat of domestic terrorism. We believe that the time to address threats of violence is before the violence occurs, so we are putting our resources into disrupting terrorist plots. We also remain committed to holding accountable those who perpetrate such attacks, which are aimed at rending the fabric of our democratic society and driving us apart.
“Today, as we remember Oklahoma City, we must stand together against the kind of hatred that leads to tragedies like that one. Today, we are also reminded of the grace and resilience demonstrated by the Oklahoma City community, which refused to allow hate and division to win.”
- Florida Businesswoman Pleads Guilty to Criminal Health Care and Tax Fraud Charges and Agrees to $20.3 Million Civil False Claims Act Settlement
February 4, 2021A Florida businesswoman has agreed to resolve criminal charges and civil claims arising out of false claims to the United States for braces and other durable medical equipment (DME), the Justice Department announced today.
- Fugitive Charged with Leading Multimillion Dollar Fraud Scheme, Falsifying Evidence, and Tax Crimes
October 15, 2020An American citizen was charged in two indictments unsealed this week for his alleged participation in an investment fraud scheme in which he allegedly misappropriated $6.1 million in investor-funds, manufactured evidence to mislead an investigation by the Securities and Exchange Commission (SEC) and concealed the proceeds of his fraudulent scheme from the IRS.
- COVID-19: VA Should Assess Its Oversight of Infection Prevention and Control in Community Living Centers
July 29, 2021What GAO Found The Department of Veterans Affairs (VA) took steps—such as issuing guidance and trainings—to support the response to the COVID-19 pandemic in Community Living Centers (CLC), which are VA-owned and -operated nursing homes. This guidance focused on, for example, limiting CLC entry and testing residents and staff for COVID-19, while the trainings were intended to prepare staff for, among other things, a surge in cases. However, the agency conducted limited oversight of infection prevention and control in these facilities during the first year of the pandemic, from March 2020 through February 2021. In particular, the agency suspended annual in-person inspections of CLCs before resuming them virtually in February 2021. The agency also required that CLCs conduct a one-time self-assessment of their infection prevention and control practices but did not review the results in a timely manner to make more immediate improvements. VA officials acknowledged these shortcomings as the agency responded in real time to the rapidly evolving pandemic. As VA has described this time as a “learning period,” it could benefit from assessing its decisions and actions related to oversight of infection prevention and control during the pandemic to identify any lessons learned. Such an assessment would align with VA’s plans to assess and report on the agency’s overall response to the pandemic as well as its strategic goal to promote continuous quality improvement in CLCs. Results from such an assessment—which could look at both successes and missed opportunities—could help VA better prepare for future infectious disease outbreaks in CLCs. Why GAO Did This Study Close to 8,000 veterans per day received nursing home care provided by VA in CLCs in fiscal year 2020. COVID-19 has posed significant risks to nursing home residents and staff, as residents are often in frail health, and residents and staff have close daily contact with each other. The CARES Act includes a provision that GAO monitor the federal response to the pandemic. This report describes, among other objectives, guidance and training VA has issued to help CLCs respond to the pandemic and examines VA’s oversight of infection prevention and control in CLCs during the pandemic. GAO analyzed documents, including guidance, training-related materials, and CLC self-assessments of their infection prevention and control practices. GAO also interviewed VA officials and CLC staff, the latter from five facilities selected based on factors such as having been cited for infection prevention and control deficiencies prior to the pandemic.
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September 24, 2021Attorney General Merrick B. Garland today announced the appointment of David L. Neal as the Director of the Executive Office for Immigration Review (EOIR) at the Department of Justice.
- VA Health Care: Community Living Centers Were Commonly Cited for Infection Control Deficiencies Prior to the COVID-19 Pandemic
February 5, 2021The Department of Veterans Affairs (VA) is responsible for overseeing the quality of nursing home care provided to residents in VA-owned and -operated community living centers (CLC). VA models its oversight process on the methods used by the Centers for Medicare & Medicaid Services, which uses inspections of nursing homes to determine whether the home meets federal quality standards. These standards require, for example, that CLCs establish and maintain an infection prevention and control program. VA uses a contractor to conduct annual inspections of the CLCs, and these contractors cite CLCs with deficiencies if they are not in compliance with quality standards. Infection prevention and control deficiencies cited by the inspectors can include situations where CLC staff did not regularly use proper hand hygiene or failed to correctly use personal protective equipment. Many of these practices can be critical to preventing the spread of infectious diseases, including COVID-19. GAO analysis of VA data shows that infection prevention and control deficiencies were the most common type of deficiency cited in inspected CLCs, with 95 percent (128 of the 135 CLCs inspected) having an infection prevention and control deficiency cited in 1 or more years from fiscal year 2015 through 2019. GAO also found that over the time period of its review, a significant number of inspected CLCs—62 percent—had infection prevention and control deficiencies cited in consecutive fiscal years, which may indicate persistent problems. An additional 19 percent had such deficiencies cited in multiple, nonconsecutive years. Why GAO Did This Study COVID-19 is a new and highly contagious respiratory disease causing severe illness and death, particularly among the elderly. Because of this, the health and safety of the nation’s nursing home residents—including veterans receiving nursing home care in CLCs—has been a particular concern. GAO was asked to review the quality of care at CLCs. In this report, GAO describes the prevalence of infection prevention and control deficiencies in CLCs prior to the COVID-19 pandemic. Future GAO reports will examine more broadly the quality of care at CLCs and VA’s response to COVID-19 in the nursing home settings for which VA provides or pays for care. For this report, GAO analyzed VA data on deficiencies cited in CLCs from fiscal years 2015 through 2019. Using these data, GAO determined the most common type of deficiency cited among CLCs, the number of CLCs that had infection prevention and control deficiencies cited, and the number of CLCs with repeated infection prevention and control deficiencies over the period from fiscal years 2015 through 2019. GAO also obtained and reviewed inspection reports and corrective action plans to describe examples of the infection prevention and control deficiencies cited at CLCs and the CLCs’ plans to remedy the noncompliance. For more information, contact Sharon M. Silas at (202) 512-7114 or SilasS@gao.gov.
- COVID-19: Lessons Learned from Interior and Treasury’s Administration of CARES Act Funds Could Improve Federal Emergency Relief to Tribes
October 29, 2021What GAO Found The Department of the Interior distributed the CARES Act Operation of Indian Programs (OIP) appropriation through existing programs while the Department of the Treasury had to set up a new program to distribute the Coronavirus Relief Fund (CRF) Tribal Government Set-Aside. This resulted in tribes taking fewer steps to access and use Interior’s OIP appropriation than Treasury’s program. Interior. The CARES Act required that Interior make at least $400 million of the OIP appropriation available to meet the direct needs of tribes. Interior disbursed these funds through two existing programs based on tribal enrollment. As a result, tribes needed to take few administrative steps to access and use funds. Treasury. The CARES Act created the CRF as a new program. The CRF appropriation included an $8 billion Tribal Set-Aside. Treasury did not have a preexisting allocation methodology or mechanisms for disbursing this funding to tribes, so it had to develop them before it could make payments. Treasury distributed the CRF Tribal Set-Aside in two tranches, using multiple allocation methodologies. Treasury asked tribes to take several administrative steps to access and use CRF payments. For example, tribes had to submit two rounds of data to receive both tranches of CRF payments. Agencies and selected tribes faced various challenges regarding the CARES Act OIP appropriation and CRF Tribal Set-Aside. Treasury faced greater challenges than Interior, and was delayed distributing CRF payments to tribes. For example: Treasury officials said the work needed to develop distribution formulas consistent with the CARES Act contributed to delays in CRF disbursements to tribes. Selected tribes told GAO that Treasury used certain data in one of its allocation methodologies without consulting with tribes about the data and their limitations. Such consultation could have allowed the agency to make changes or address tribes’ concerns prior to making payments using the data. Consequently, certain tribes did not receive emergency relief in a timely manner to address pandemic needs. Selected tribal organizations, academic researchers, and tribes said that adjusting to Treasury’s changing guidance on allowable uses of funds further delayed tribes’ implementation of projects and increased their administrative burden. Treasury has applied some lessons learned to its administration of a subsequent relief program established by the American Rescue Plan Act of 2021. For example, Treasury improved its communication to tribes on allowable use of funds. However, Treasury has not formalized other lessons learned into its tribal consultation policy. Specifically, Treasury’s tribal consultation policy does not call for the agency to consult with tribes on data it is considering using to make policy decisions with tribal implications. Until Treasury updates its policy, it risks using data without a meaningful dialogue with tribes about any limitations of the data. This deprives Treasury of information that tribes could provide about how to address data limitations and may increase the risk that programs might not be as effective at meeting tribes’ needs in a timely manner. Why GAO Did This Study GAO has previously found that COVID-19 disproportionately harmed the public health and economies of tribal nations in the U.S. In March 2020, the CARES Act appropriated over $9 billion for federal programs for tribes and their members—this amount included $8 billion for Treasury’s CRF Tribal Set-Aside and $453 million for Interior’s OIP (CARES Act funds). The CARES Act includes a provision for GAO to report on its ongoing monitoring and oversight efforts related to the COVID-19 pandemic. This report is part of that body of work. It examines (1) approaches Interior and Treasury took to distribute CARES Act funds to tribes and steps necessary for tribes to access and use these funds, and (2) challenges the agencies and selected tribes faced and lessons learned that could improve future federal emergency relief to tribes. To do this work, GAO reviewed agency documents and interviewed federal agency officials, representatives of three tribal organizations and two academic research centers—selected for their work related to CARES Act funds—and officials from seven selected tribes that accessed CARES Act funds from the agencies.
- Financial Assistance: Lessons Learned from CARES Act Loan Program for Aviation and Other Eligible Businesses
December 10, 2020The CARES Act authorized up to $46 billion for the Department of the Treasury (Treasury) to make loans to aviation and other eligible businesses affected by the COVID-19 pandemic. Of the 267 applications submitted to the loan program, 35 loans providing $21.9 billion in assistance were executed. Treasury officials do not expect to make any additional loans before Treasury’s authority to make loans expires. Applications and Loans for CARES Act Loan Program for Aviation and Other Eligible Businesses, by Category in Statute Type of business Number of applications submitted Assistance sought/available (billions of dollars) Number of loans executed Assistance provided (billions of dollars) Passenger air carrier, repair station operator, and ticket agent 183 35 / 25 23 21.2 Cargo air carrier 10 0.8 / 4 1 0.002 National security business 74 2.6 / 17 11 0.7 Total 267 38.3 / 46 35 21.9 Source: GAO analysis of Department of the Treasury data | GAO-21-198 Note: Pub. L. No. 116-136, § 4003(b)(1)-(3). Participation in the loan program varied across business types due to timing of decisions and other factors, according to stakeholders. Treasury prioritized applications from the largest passenger air carriers and executed loans with seven of them for nearly $20.8 billion. For other applicants, including smaller passenger air carriers and ticket agents, the amount of time Treasury took to evaluate their applications and other challenges affected the number of loans executed, according to selected industry associations. Treasury’s authority to make new loans under this program is set to expire in December 2020, and the loan program offers Congress and Treasury lessons for designing and implementing programs of this type in the future. For example: Multiple programs, or multiple paths within a program, may better accommodate businesses of varied types and sizes. It is difficult to implement a program quickly for a wide range of businesses. In addition, a loan program well suited to large, financially sophisticated applicants will not likely be well suited to smaller businesses. Setting and communicating clear program goals could better align lender and borrower expectations. Treasury viewed itself as a lender of last resort but did not state this view in published documents. This omission led to some applicants being surprised by parts of the process, such as when Treasury encouraged over a third of all applicants to apply to another loan program before continuing to pursue a loan from Treasury. Communicating clear timelines for action can also help align lender and borrower expectations. The lack of a published timeline resulted in frustration among some applicants when loans were not made more quickly. The COVID-19 pandemic has resulted in catastrophic loss of life and substantial damage to the global economy, including the aviation sector. U.S. passenger air carriers have lost almost $20 billion and over 47,000 jobs in 2020, with losses forecast to continue into 2021. In March 2020, Congress passed, and the President signed into law, the CARES Act, which provides over $2 trillion in emergency assistance and health care response for individuals, families, and businesses affected by the COVID-19 pandemic, including businesses in the aviation sector. The CARES Act contained a provision for GAO to review the loans provided under the Act. This report examines, among other things, eligible businesses’ participation in the loan program and lessons learned from the program for Congress and Treasury. GAO reviewed Treasury documents and data on applications received and loans executed; interviewed Treasury officials on the design and implementation of the program; and interviewed eight industry associations that represent the range of businesses eligible for loans, eight passenger air carriers, and other selected applicants to gather their views on the program. GAO will continue to monitor and report on CARES Act assistance to the aviation industry. This oversight includes the loan program and another Treasury program—the Payroll Support Program—that provided assistance to certain aviation businesses to continue paying employee wages, salaries, and benefits. For more information, contact Heather Krause at (202) 512-2834 or email@example.com.
- Over-The-Counter Drugs: Information on FDA’s Regulation of Most OTC Drugs
July 30, 2020The Food and Drug Administration (FDA) has regulated most over-the-counter (OTC) drugs—that is, drugs available without a prescription—through the OTC monograph process. FDA has described an OTC monograph as a “rulebook” for marketing safe and effective OTC drugs, such as aspirin, cough and cold medicine, and hand sanitizer. OTC monographs established conditions—such as active ingredients, indications for use, dosage forms, and product labeling—under which an OTC drug was generally recognized as safe and effective. According to FDA officials, before the CARES Act, which was enacted in March 2020, the agency’s ability to update and finalize monographs in response to safety issues and to reflect new scientific information was limited by the rulemaking process the agency was required to follow, as well as insufficient resources. Agency officials estimated that it took at least 6 years to complete the required rulemaking process. Additionally, the agency reported it was critically under-resourced to regulate the estimated 100,000 OTC drugs marketed through the monograph process. However, the CARES Act provided for a new process to regulate these OTC drugs rather than the rulemaking process. FDA officials expect it will take less time to update and finalize requirements for OTC drugs using the new process. The CARES Act also authorized FDA to assess user fees to provide additional resources to regulate OTC drugs. Although FDA officials said this new process and user fees should improve its regulation of OTC drugs, the agency’s analysis of the effect of the CARES Act is still ongoing. FDA officials told GAO that prior to the CARES Act, they used various methods to identify and respond to safety issues related to OTC drugs. For example, to identify these issues, FDA officials said they read medical literature related to safety issues and reviewed reports submitted to the agency’s adverse event reporting system. To respond to these issues, FDA took steps such as issuing drug safety communications to consumers and requesting that manufacturers make changes to a drug’s labeling. For example, in 2015, two FDA advisory committees recommended that cough and cold drugs with codeine be removed from the relevant OTC monograph for use in drugs in children. In 2018, FDA also issued a drug safety communication stating the risks outweighed the benefits for the use of these drugs in children. However, FDA officials said these methods were not a substitute for rulemaking because manufacturers could legally market their OTC drugs without making requested safety changes until the rulemaking process was completed. According to FDA officials, the new process for regulating OTC drugs included in the CARES Act could improve FDA’s ability to address identified safety risks in a more timely and efficient manner in the future. The act established an expedited process to address safety issues that pose an imminent hazard to public health or to change a drug’s labeling to mitigate a significant or unreasonable risk of a serious adverse event. OTC drugs prevent and treat a variety of conditions; for example, sunscreen is used to help prevent sunburn. FDA officials and stakeholders, such as industry representatives and patient and provider groups, have questioned whether the monograph process used to regulate most OTC drugs has been overly burdensome and has limited FDA’s ability to quickly update and finalize monographs in response to potential safety issues for consumers. Enacted in March 2020, the CARES Act changed how FDA regulates OTC drugs. The Sunscreen Innovation Act included a provision for GAO to review FDA’s regulation of OTC drugs. This report describes, among other issues, (1) the factors that affected FDA’s ability to regulate OTC drugs and (2) how FDA identified and responded to safety issues associated with these drugs. GAO reviewed federal statutes and agency documents and interviewed FDA officials and stakeholders familiar with the monograph process. These stakeholders included representatives from the OTC drug industry, health care provider and consumer groups, and researchers. The Department of Health and Human Services provided technical comments on this report, which GAO incorporated as appropriate. For more information, contact John E. Dicken at (202) 512-7114 or firstname.lastname@example.org.
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- Attorney General Merrick B. Garland Delivers Remarks at the National Organization of Black Law Enforcement Executives (NOBLE) 2022 Winter CEO Symposium
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- Notice of Funding Opportunity (NOFO): DRL Anti-Corruption and Election Integrity Programs in the Balkans
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- Missile Defense: Observations on Ground-based Midcourse Defense Acquisition Challenges and Potential Contract Strategy Changes
October 21, 2020The Missile Defense Agency (MDA) is developing a system to defend the U.S. from long-range missile attacks. As MDA continues to develop this system, called Ground-based Midcourse Defense (GMD), it has opportunities to incorporate into its approach lessons learned from over 2 decades of system development. MDA has made progress in developing and fielding elements of the GMD system. For example, MDA is constructing a new missile field to expand the fleet of interceptors. However, MDA has also experienced significant setbacks. Most recently, the Department of Defense canceled development of a key GMD element, the Redesigned Kill Vehicle, in 2019 because of fundamental problems with the system’s design. Ongoing Construction of a New Ground-based Midcourse Defense Interceptor Field (July 16, 2019) Over the years, GAO has identified practices that MDA could apply to the GMD program to improve acquisition outcomes, such as: Using knowledge-based acquisition practices Involving stakeholders early and often Providing effective oversight Promoting competition Performing robust testing GAO has also made numerous recommendations to improve MDA’s acquisition outcomes and reduce risk. As of July 2020, the department has concurred with most of the recommendations GAO made since MDA’s inception in 2002. Although the department has implemented many of the recommendations, it has further opportunities to implement the remaining open recommendations and apply lessons learned on a major, new effort to develop a next-generation GMD interceptor. Since the late 1990s, DOD has executed the GMD program through a prime contractor responsible for developing and integrating the entire weapon system. MDA is considering taking over these responsibilities for GMD for the next phase of the program. GAO found that this approach offers potential benefits to the agency, such as more direct control over and greater insight into GMD’s cost, schedule, and performance. However, the approach has some challenges that, if not addressed, could outweigh the benefits. For example, MDA may encounter challenges obtaining the technical data and staffing levels necessary to manage this complex weapon system, which could ultimately affect its availability or readiness. As of October 2020, MDA has not yet determined an acquisition strategy for the next phase of the GMD program. The GMD system aims to defend the U.S. against ballistic missile attacks from rogue states like North Korea or Iran. DOD has been developing this system since the 1990s and has spent $53 billion on the system so far. GMD is a complex system that includes interceptors and a ground system, and MDA has largely relied on a contractor, Boeing, to manage development and system integration. MDA is considering moving away from this approach as the program embarks on developing a key element of the GMD, a new interceptor. The House Armed Services Committee included a provision in a report for GAO to assess the GMD contract structure and identify potential opportunities to improve government management and contractor accountability. This report addresses (1) the lessons learned from challenges MDA encountered acquiring the GMD system and (2) the potential benefits and risks of MDA taking over system integration responsibilities for GMD. To conduct this work, GAO reviewed GMD program documentation, prior GAO reports on missile defense, GAO interviews with other DOD components, and expert panel reviews of GMD. GAO also spoke with officials from MDA and other DOD components. GAO has 17 open recommendations aimed at improving missile defense acquisition outcomes and reducing risk. Recently, DOD has taken steps to address some of these open recommendations, but further action is needed to fully implement the remaining recommendations. For more information, contact W. William Russell at (202) 512-4841 or email@example.com.
- Medtronic to Pay Over $9.2 Million To Settle Allegations of Improper Payments to South Dakota Neurosurgeon
October 29, 2020Minnesota-based medical device maker Medtronic USA Inc. has agreed to pay $8.1 million to resolve allegations that it violated the False Claims Act by paying kickbacks to induce a South Dakota neurosurgeon to use certain Medtronic products, the Department of Justice announced today. Medtronic also agreed to pay an additional $1.11 million to resolve allegations that it violated the Open Payments Program by failing to accurately report payments it made to the neurosurgeon to the Centers for Medicare & Medicaid Services (CMS).
- Military Suicide: Preliminary Observations on Actions Needed to Enhance Prevention and Response Affecting Certain Remote Installations
April 6, 2022What GAO Found The Department of Defense’s (DOD) suicide prevention and response efforts have faced challenges, according to GAO’s preliminary analysis. These include assessing suicide risk at remote installations outside the contiguous U.S. (OCONUS), implementing key prevention activities, integrating prevention in primary care, and providing response guidance and training for key personnel. Suicide risk at remote OCONUS installations. GAO’s preliminary analysis suggested that remote OCONUS installations accounted for a slightly higher proportion of reported suicide attempts, but a lower proportion of reported suicide deaths relative to the proportion of servicemembers assigned to these locations in 2016-2020. DOD and military service officials stated that suicide deaths at OCONUS installations may be lower because servicemembers assigned to installations outside the U.S. have limited access to non-military issued firearms. Separately, DOD-, service-, and installation-level officials GAO interviewed identified risk factors for suicide and related challenges at remote OCONUS installations, such as less access to mental health services and increased isolation. However, DOD has not fully assessed suicide risk at these installations. Establishing a process to do so could enhance related suicide prevention efforts. Policies, programs, and activities. DOD and the military services have established suicide prevention policies, programs, and activities—such as training and mental health resources—for servicemembers and dependents, including those assigned to remote OCONUS installations. However, gaps exist in implementation. For example, the Army, the Navy, and the Marine Corps have not ensured implementation of some prevention activities, such as establishing required prevention teams at installations. By establishing oversight mechanisms, these services may have greater assurance that such activities are implemented across all installations, including remote OCONUS locations. Privacy protection and suicide prevention in primary care. DOD and the military services have established privacy protections for servicemembers and dependents seeking suicide prevention care. DOD has also taken steps to integrate suicide prevention into primary care by establishing screening requirements and embedding behavioral health personnel in some primary care clinics. However, GAO’s preliminary analysis found that DOD has experienced staffing shortages for these personnel, in part because it has not developed a strategy to address hiring challenges. By developing such a strategy, DOD can enhance the provision of behavioral health care to servicemembers and dependents, including at remote OCONUS installations. Guidance and training for key personnel. DOD and the military services have established some suicide response guidance and training for key personnel, but gaps exist. For example, DOD has established guidance that fully addresses commanders’ response to suicide deaths, but not suicide attempts. Further, according to GAO’s preliminary analysis, DOD has not established statutorily required training for commanders on responding to suicide deaths and attempts. By establishing comprehensive suicide response guidance and training for commanders, DOD can better ensure that commanders are prepared to provide support to suicide attempt survivors and the bereaved. Why GAO Did This Study Suicide deaths and attempts within the military community are devastating events for families. They can also harm unit morale and readiness. Remote OCONUS installations may pose challenges that increase suicide risk. This statement examines, among other things, (1) the incidence of suicide and related risk factors among servicemembers at remote OCONUS installations during 2016-2020. It also discusses the extent to which DOD and the military services have, in relation to remote OCONUS installations (2) established and ensured implementation of policies, programs, and activities that address suicide prevention; (3) established privacy protections for servicemembers and dependents seeking suicide prevention care and integrated suicide prevention into primary care; and (4) established guidance and training for key personnel for responding to suicide deaths and attempts. This preliminary analysis is included in GAO’s draft report, which was provided to DOD in March for review and comment. For that report, GAO analyzed data, policies, and guidance; reviewed documentation from 57 installations; and interviewed DOD and military service officials.
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- Justice Department And Indian Authorities Announce Enforcement Actions Against Technical-Support Fraud Scheme Targeting Seniors
October 15, 2020A federal court has ordered an individual and 5 companies to stop engaging in a technical-support fraud scheme that is alleged to have defrauded hundreds of elderly and vulnerable U.S. victims, the Department of Justice announced today.