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, voluntary 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) around the country. 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, 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. 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.
Litigation & Defense
· Counsel for cardiologists in qui tam False Claims Act 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 (D.D.C. No. 1:08-cv-01626-RMC), a suit challenging the CMS Stark Law regulations
· Counsel to a hospital executive and his management company in United States v. Jones (5th Cir. January 16, 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
· Represented academic physician groups in considering restructuring options to better face health care reform challenges.
· Led audit team of an academic medical center's compliance program
· Represented numerous cardiology practices in developing strategic relationships with hospitals
· Represented national trade association in seeking Stark law regulatory changes
· Recognitions & Awards
· Best Lawyers in America: Health Care Law (2011 - 2013)
· Chambers USA: Massachusetts - Healthcare (2009 - 2012)
· Massachusetts Super Lawyers: Criminal Defense: White Collar (2004 - 2012)
· Martindale-Hubbell AV Preeminent
· Nightingale's Healthcare News: Outstanding Fraud and Compliance Lawyers (2004)
Professional & Community Involvement
· Advisory Board, Health Care Fraud Report, published by the Bureau of National Affairs, Inc.
· 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
· 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
· Chairman, Weston (Massachusetts) Town Meeting Advisory Committee to Town Moderator
(Also at Boston, Massachusetts Office)