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Thomas S. Crane

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[email protected]

+1.617.348.1676

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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.

Education

  • Antioch College (JD)
  • University of Michigan (MHA)
  • Harvard University (BA)

Experience

  • 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

Recognition & Awards

  • Included on the Massachusetts Super Lawyers: Criminal Defense: White Collar list (2004 – 2012, 2014 – 2017, 2019)
  • 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 – 2020)
  • Chambers USA: Massachusetts – Healthcare (2009 – 2012, 2015 – 2020)
  • Martindale-Hubbell AV Preeminent
  • Nightingale’s Healthcare News: Outstanding Fraud and Compliance Lawyers (2004)

Involvement

  • 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

Viewpoints

MACRA: Program Integrity and Fraud and Abuse Provisions

April 23, 2015 | Blog | By Thomas Crane, Samantha Kingsbury

On Thursday April 16th, President Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”). Pub.L. 114-10. In two previous posts, we discussed MACRA’s repeal of the Sustainable Growth Rate formula (the “SGR”) and physician payment reform, and the payment provisions and offsets established by MACRA.
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In my post of April 2, Divided Supreme Court Restricts Provider Challenges to State Medicaid Rates, I wrote about the March 31st Supreme Court decision that providers may not sue in federal court over the adequacy of state Medicaid rates (See Armstrong v. Exceptional Child Ctr., Inc. (“Exceptional Child Center”).
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Beyond SGR - MACRA Provides Additional Payment Provisions and Offsets

April 21, 2015 | Blog | By Thomas Crane, Lauren Moldawer

This is the second post in our continuing series on the Medicare Access and CHIP Reauthorization Act (MACRA). Pub.L. No: 114-10. In addition to repealing the Sustainable Growth Rate (SGR), which was covered in our April 20th post, MACRA includes several other payment provisions and offsets totaling $39.5 billion in savings over ten years.
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With SGR Repealed, Replacement Policy Creates New Priorities

April 20, 2015 | Blog | By Thomas Crane

On April 16, 2015, President Obama signed into law, the “Medicare Access and CHIP Reauthorization Act of 2015” (MACRA), ending annual temporary patches and massive lobbying efforts since the late 1990s to prevent significant reimbursement cuts for physicians serving Medicare beneficiaries caused by the so-called Sustainable Growth Rate (SGR) formula.
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A divided Supreme Court ruled by a 5-4 margin on March 31st that providers may not sue in federal court over the adequacy of state Medicaid rates. The decision in Armstrong v. Exceptional Child Ctr., Inc. has important implications well beyond the narrow group of providers of “habilitation” services for the mentally retarded in the state of Idaho.
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This week, two of Mintz health law attorneys will speak at the American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues in Baltimore, Maryland.
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On February 10, 2015, in United States v. Patel (Case No. 14-2607), the Seventh Circuit Court of Appeals ruled that a physician makes a “referral” within the meaning of the federal health care programs Anti-Kickback Statute (AKS).
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Bloomberg BNA recently published a Health Care Fraud Report entitled Outlook 2015: Uptick Expected in Stark, Anti-Kickback FCA Cases, Self-Disclosures, which examines the top issues for health care providers and suppliers to watch in 2015.  
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Last Friday, the HHS Office of the Inspector General issued a highly anticipated proposed rule that provides new and modified regulatory safe harbors to the Anti-Kickback Statute, amends regulatory provisions related to enforcement of the Beneficiary Inducement Civil Monetary Penalty Law (CMP) provisions, and attempts to narrow the prohibitions covered by the Gainsharing CMP.
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Proposed Rule Issued by OIG Realigns Its Enforcement Views with Health Care Reform Goals

October 9, 2014 | Alert | By Theresa Carnegie, Thomas Crane, Carrie Roll, Stephanie Willis

Fridays never seem to be slow in the health care regulatory world. On Friday, October 3rd, the HHS Office of the Inspector General (OIG) issued a highly anticipated proposed rule (the Proposed Rule) that provides amendments to the Anti-Kickback Statute’s regulatory safe harbors (AKS Safe Harbors) and adds protections for increasingly common payment practices and business arrangements under the Civil Monetary Penalty Law (CMP).
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News & Press

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Mintz Member Thomas Crane and Associate Xavier Hardy co-authored a Bloomberg Law Insights article discussing the COVID-19 pandemic’s impact on the Affordable Care Act (ACA), specifically the staggering unemployment numbers’ emphasis on the ACA’s measures to increase coverage.
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Mintz Member and Chair of the Health Law Practice Karen S. Lovitch served as an editor of the Fifth Edition of the American Health Lawyers Association’s “Health Care Compliance Legal Issues Manual,” which provides strategies for addressing the full scope of legal issues critical to health care compliance. Mintz Member Thomas S. Crane also contributed to the publication as an author.
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Mintz partner and Massachusetts lawyer Julie Korostoff is one of 49 attorneys recognized as “Leaders in Their Fields” by the 2018 Chambers USA: America's Leading Lawyers for Business guide. Chambers named Korostoff a “Recognized Practitioner” in Technology.
In looking ahead to 2018 health care trends, Mintz Member Tom Crane, a fraud and abuse and health care enforcement defense attorney, is referenced in the Bloomberg Law article on possible changes to the Stark Law in 2018.
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Best Lawyers named 85 Mintz attorneys to its 2018 list of The Best Lawyers in America. In addition, Mintz attorneys Matthew J. Gardella and Samuel M. Tony Starr were named “Lawyer of the Year” in their respective practice areas.
Member Tom Crane authors this article discussing the decision by the Fourth Circuit court of Appeals in United States ex rel. Drakeford v. Tuomey. The judgment premised on Stark Law violations, and was, according to some, not grounded in Stark Law regulations.
This article notes that due to the Trump administration’s delay of a program integrity final rule fraud enforcement could become more of a challenge. Mintz health care attorneys Ellyn Sternfield and Tom Crane weigh in on the issue.
Thomas S. Crane, a Member of the Health Law Practice at Mintz, is speaking on a panel at the Advanced Forum on False Claims and Qui Tam Enforcement. The event is sponsored by the American Conference Institute.
In this Bloomberg BNA Health Law Resource Center article, Tom Crane discusses the potential consequences of reforming Stark law. Tom is known for his fraud and abuse defense work and is involved in Mintz’s Health Care Enforcement Defense Practice.
Mintz Member Tom Crane is quoted in this Modern Healthcare article discussing the American Hospital Association’s request to President-elect Trump to cancel Stage 3 of the meaningful use program.
Fifty-three Mintz attorneys have been named Massachusetts Super Lawyers for 2016 and thirty-one have been named Massachusetts Rising Stars. The findings will be published in the November 2016 issue of Boston Magazine and in a stand-alone magazine, New England Super Lawyers. 
Best Lawyers named 73 Mintz attorneys to its 2017 list of The Best Lawyers in America. Mintz attorneys selected for inclusion in this year’s list span 44 practice areas. 
Firm’s National Healthcare Practice, NY Corporate/M&A and Litigation: General Commercial Among Newest Rankings
Mintz Member Tom Crane is quoted in this BNA’s Health Care Daily Report article discussing the expectation that the health care industry will face increased False Claims Act cases and enforcement actions in 2016.
The 2015 Chambers USA: America's Leading Lawyers for Business guide names 52 Mintz, Cohn, Ferris, Glovsky and Popeo, P.C.  attorneys as “Leaders in Their Fields.”
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Mintz Member and Chair of the Health Law Practice Karen S. Lovitch, Member Thomas S. Crane, and Associate Samantha P. Kingsbury co-authored a book published by the American Bar Association examining the federal Anti-Kickback Statute, one of the best-known federal fraud and abuse statutes, which prohibits transactions intended to induce or reward referrals for items or services reimbursed by the federal health care programs. The criminal statute has wide-ranging effects on business relationships in the health care, pharmaceutical, and medical device sectors.

Events

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