Qui Tam & Health Care

Federal and State False Claim Act laws allow whistleblowers and consumers to sue individuals and companies who falsely bill the government.  These cases are called “qui tam” lawsuits (“Qui Tam” is a latin phraze that means “to represent the king”)

Fraudulent and false billings by health care providers and other government contractors cost government hundeds of billions of dollars each year.  Qui Tam lawsuits encourage and reward private citizens who uncover and prosecute fraudulent government billing.

Grande Law Offices has been at the forefront of legislative, litigation, educational and public interest initiatives on behalf of qui tam whistleblowers and the government.

Grande Law Offices helped draft and lobbied for the Hawai’i False Claims Act and the Hawai’i County False Claims Act as well as legislation to prevent double taxation of whistleblowers.

Grande law Offices has obtained the highest Medicare qui tam settlements in Hawai’i and the first recovery under the Hawai’i False Claims Act.

Grande Law Offices principal Thomas Grande is the co-founder and past co-chair of the Qui Tam Litigation Group of the Association of Trial Lawyers of America (now American Association for Justice) and has given numerous educational seminars at national and state conferences held by the Taxpayers Against Fraud and the Association of Trial Lawyers of America.

Grande Law Offices has given numerous trainings to coders, nurses, doctors and others to help them stop and protect themselves if their employer is engaging in fraud.

Grande Law Offices has actively worked to improve the quality of health care delivered to our citizens, particularly seniors and the poor. Cases aimed at improving the quality of health care delivered to our citizens comprise an important part of Grande Law Offices’s commitment to litigating cases which have important social effects. In conjunction with his qui tam practice, Thomas Grande has litigated several important cases which attempt to ensure that appropriate health care is delivered to our citizens.  Some of our qui tam cases have included:

• Settlement of a qui tam case against a Korean fire safety company that was falsifying fire inspection reports at military bases.

• Settlement of a qui tam case against Kaiser Hospitals for using unlicensed physical therapry personnel and billing government insurance programs.

• Settlement of a case which stopped a local doctor from fraudulent selling generic drugs to Medicaid patients, but charging the government for brand name rates.

• Litigating a case against Kaiser Hospitals in California to stop Kaiser’s practice of dispensing double dose pills and a pill splitter to its patients.

• Representing an anesthesiologist who refused to bill the government and supervise nurse practitioners while she was on-call and off the hospital grounds.

Governor Signs Hawai’i False Claims Act Amendments

Honolulu Hawai’i  July 10, 2012

Governor Neil Abercrombie signed Act 294, which amends the Hawai’i False Claims Act to conform to federal statutory amendments.  Thomas Grande testified and lobbied in favor of 1) expanding the false claim act coverage to include tax fraud and 2) expanding the amendments to include the Hawaii Counties False Claims Act.  Both proposed amendments were included in the legislation, making Hawai’i only the second state to include tax fraud in the false claims act.

To read Thomas Grande‘s Honolulu Star-Advertiser guest editorial on the Hawai’i False Claims Act, click here.

$2.5 Million Recovered in Queens Whistleblower Case

Thomas Grande and co-counsel Warren Price of Price Okamoto Himeno & Lum recovered $2.5 million in a qui tam case filed on behalf of two pharmacy technicians at The Queens Hospital in Honolulu.

The case alleged that Queens filed fraudulent Medicare and Medicaid claims by allowing residents to perform unsupervised medical procedures and allowing medications to be prescribed without the authorization of a supervising physician.

“This case ensures that hospitals and doctors will follow public health insurance guidelines for the elderly who are served by Medicare and the poor who are served by Medicaid,” said Mr. Grande.  “These guidelines ensure that quality and appropriate medical treatment is given to all of our citizens, especially those who are most vulnerable in our population,”  he said.

The lawsuit was filed under the federal False Claims Act and Hawaii False Claims Act and was settled with the assistance of the United States Attorneys Office and state Medicaid fraud unit.

Edward H. Kubo, Jr., United States Attorney for the District of Hawaii, praised the two whistleblowers for their courage in coming forward with the case.

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