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

Bar Admissions

  • District of Columbia
  • Massachusetts
  • United States Court of Appeals for the District of Columbia Circuit
  • United States Court of Appeals for the Fifth Circuit
  • United States Court of Appeals for the First Circuit
  • United States Court of Appeals for the Seventh Circuit
  • United States Court of Appeals for the Tenth Circuit
  • United States District Court for the District of Columbia
  • United States District Court for the District of Massachusetts
  • United States Supreme Court

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.

Representative Matters

Litigation & Defense

  • In March 2015, won dismissal of a criminal patient abuse complaint brought by a state Medicaid Fraud Control Unit against a skilled nursing facility and national management company, involving the death of an elderly patient in State of New Mexico v. THI of New Mexico at Albuquerque Care Center, LLC and THI of Baltimore Management, LLC (Second Judicial District Court, County of Bernalillo, New Mexico (No. D-0202-CR-2010-03648 – 03649)

  • Lead counsel representing defendant pharmacy in Thulin v. Shopko Stores Operating Co., LLC, 771 F.3d 994 (7th Cir. 2014), in which the Seventh Circuit Court of Appeals upheld the District Court’s (W.D. Wis) dismissed with prejudice of a qui tam FCA case alleging Medicaid pharmacy billing fraud, for failure to state a claim or to properly plead an actionable offense.  Prior to the formal litigation we were able to obtain the declination of the Department of Justice and all eight states in which the relator filed state FCA actions

  • Represented defendant medical device manufacturer in Arnold v. Alphatec Spine, Inc., 2014 U.S. Dist. LEXIS 87079; 2014 WL 2896838, in which the District Court (W.D. Ohio) dismissed with prejudice RICO (with underlying kickback allegations) and products liability allegations related to implantation of tissue-growth material as part of spinal device surgery

  • Counsel for cardiologists in qui tam False Claims Act (FCA) case alleging medical device company kickbacks
  • Counsel for a physician facing mandatory exclusion which led to the OIG withdrawing its action
  • Lead counsel in Colorado Heart Institute, LLC v. Leavitt, 609 F. Supp. 2d 30 (D.D.C. 2009), a suit challenging the CMS Stark Law regulations
  • Counsel to a hospital executive and his management company in United States v. Jones, 475 F.3d 701 (5th Cir. 2007), a criminal related party cost report fraud case reversing the district court’s sentencing and restitution order based on a failure of the government’s proof
  • Part of the criminal defense team in the trial of TAP managers in Boston, resulting in a Rule 29 judgment of acquittal for the firm’s client
  • Lead amici counsel to the American Hospital Association, Federation of American Hospitals, Association of American Medical Colleges, American Osteopathic Association, and Missouri Hospital Association in United States v. McClatchey, (217 F.3d 823, 10th Circ. 2000) and United States v. Lahue, (261 F.3d 993, 10th Circ. 2001), cases that challenged the application of the so-called one purpose rule which holds that a provider can be found guilty under the anti-kickback statute if one purpose in paying remuneration is to induce referrals

Compliance & Regulatory

  • Representing academic medical center in its affiliation agreements with community physicians and hospitals

  • Representing academic physician groups in considering merger options and restructuring academic affiliation with medical school 
  • Leading audit team of an integrated hospital system to determine compliance with Medicare's provider-based rules
  • Represented national medical device trade association on physician ownership issues

  • 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

  • Represented numerous cardiology practices in developing strategic relationships with hospitals
  • Represented national trade association in seeking Stark law regulatory changes
  • Served as General Counsel to an academic faculty practice plan
  • Led audit team of an academic medical center’s compliance program

Recognitions & 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 – 2018)
  • 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)

Professional & Community Involvement and Activities

  • 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