Tom is nationally recognized for his work defending health care clients against anti-kickback, Stark Law, false claims, and whistleblower allegations. His work includes litigation, internal investigations, corporate integrity agreements, and self-disclosures. Tom also counsels clients on the legal, practical, and fraud and abuse implications of business arrangements and sales and marketing practices. Additionally, Tom has worked with several academic medical center clients in restructuring arrangements among medical school, teaching hospital, and faculty physicians. Tom gained national recognition for his work on the anti-kickback statute during his tenure at the HHS Office of Inspector General, where he prosecuted the Hanlester Network case and was the principal author of the 1991 safe harbor regulations. He is an elected Fellow of the American Health Lawyers Association.
Tom is nationally recognized for his experience with fraud and abuse. Practicing in Boston and Washington, DC, he advises national and local clients on structuring complex strategic affiliation arrangements and transactions to comply with the applicable fraud and abuse laws as well as the variety of other regulatory requirements to meet today’s health reform challenges. His work in defending clients against anti-kickback, Stark Law, false claims, and whistleblower allegations includes litigation, internal investigations, self-disclosures, and negotiating settlements and Corporate Integrity Agreements (CIAs).
He has appeared before numerous US attorneys’ offices, the FBI, and the Office of Inspector General (OIG) and Centers for Medicare & Medicaid Services (CMS) around the country and in Washington. In addition, he has served as an expert witness and consulting expert in health care fraud cases.
In addition to his fraud and abuse defense work, Tom advises clients on the legal, practical, and fraud and abuse implications of business arrangements and sales and marketing practices. This part of his practice focuses on Medicare and Medicaid fraud and abuse compliance and reimbursement issues and related laws, including the federal Physician Payments Sunshine Act, ‘meaningful use’ of EHR technology, under arrangement and provider-based rules, and OIG issues.
Tom has implemented and audited comprehensive corporate compliance programs for clients in various health care sectors.
His clients have included hospital systems and executives, medical device and pharmaceutical manufacturers, pharmacies and pharmacy benefit management companies, physicians and groups, renal dialysis providers, supply companies, home care providers as well as national and state trade groups.
Tom has served in leadership positions with the American Health Lawyers Association (AHLA), the largest organization of health care attorneys in the country, including election as a Fellow (as only the third private-practice fraud and abuse attorney elected), which is one of AHLA’s highest recognition for lifelong leadership. He has written numerous articles, lectures frequently to health care providers and attorneys critiquing government fraud and abuse enforcement policies, and has extensive knowledge regarding the ethics of financial relationships among health care providers.
He became nationally known for his work on the anti-kickback statute during his tenure at the Office of Inspector General at the Department of Health and Human Services in Washington, DC. In particular, Tom gained recognition as a prosecutor in the Hanlester Network joint venture case and as the principal author of the 1991 safe harbor regulations.
- Antioch College (JD)
- University of Michigan (MHA)
- Harvard University (BA)
- Representing academic physician groups in considering merger options and restructuring academic affiliation with medical school
- Represented numerous cardiology practices in developing strategic relationships with hospitals
- Represented hospitals and other providers in self-disclosures to the OIG, CMS and US Attorneys’ Offices for potential Stark Law, Anti-Kickback and FCA violations
- Secured a dismissal of a False Claims Act suit brought by an ex-employee whistleblower who accused the company of knowingly overcharging Medicaid for the cost of pharmaceuticals.
- Representing non-profit academic medical practice plans in restructuring their relationship with the medical school with which they are affiliated.
- Advised University Physicians, Inc., a physician group organized by six Rhode Island-based, tax-exempt faculty practice plans at the Warren Alpert School of Medicine of Brown University (SOM) and Rhode Island Hospital, with respect to an affiliation agreement with a new unifying entity, Brown Physicians, Inc. (BPI).
Recognition & Awards
- Elected a Fellow of the American Health Lawyers Association (as only the third private-practice fraud and abuse attorney elected), which is one of AHLA’s highest recognition for lifelong leadership (2015).
- Recognized by the The Legal 500 United States for Healthcare: Service Providers (2014 – 2015)
- Best Lawyers in America: Health Care Law (2011 – 2019)
- Chambers USA: Massachusetts – Healthcare (2009 – 2012, 2015 – 2018)
- Included on the Massachusetts Super Lawyers: Criminal Defense: White Collar list (2004 – 2012, 2014 – 2017)
- Martindale-Hubbell AV Preeminent
- Nightingale’s Healthcare News: Outstanding Fraud and Compliance Lawyers (2004)
- Board of Directors, Massachusetts Medical Device Industry Council (MassMEDIC)
- Member, Bloomberg Law’s Health Law and Business Editorial Advisory Board
- Founding chairman, Fraud and Abuse, Self-Referrals, and False Claims Committee; Past member, Program Committee, AHLA/HCCA Annual Fraud and Abuse and Compliance Forum; Member, Technology Task Force: AHLA
- Neutral arbitrator, AHLA
- Member, Massachusetts Bar Association (Health Section)
- Member, District of Columbia Bar Association (Health Law Section, Steering Committee 1987 – 1990)
- Board of Directors, (Executive Committee, Audit Committee Chairman) Marine Biological Laboratory, Woods Hole, Massachusetts
- Town Moderator, Weston, Massachusetts (previously Assistant Town Moderator, 2011-2012, and Chairman, Town Meeting Advisory Committee, 2012)
- Tom is a life-long sailor, including racing and white water passages