Thomas Gustafson, Ph.D., is Senior Policy Advisor at Arnold & Porter Kaye Scholer, where he concentrates on health care policy and reimbursement issues. He spent 32 years at the Department of Health and Human Services, in the Office of the Assistant Secretary for Planning and Evaluation and in the Centers for Medicare & Medicaid Services, where he held several executive posts responsible for Medicare and Medicaid legislation, strategic planning, research and demonstrations, and development and implementation of regulations.
From 2003 to 2007, Dr. Gustafson served as Deputy Director of the Center for Medicare Management (CMM), which coordinated the fee-for-service portion of the Medicare program and set payment rates for more than a million providers. He supervised coding and payment policies affecting approximately $300 billion in Medicare spending on hospitals, physicians, nursing facilities, home health agencies, and other providers. He led the development and introduction of the hospital outpatient prospective payment system and major improvements in Medicare’s other payment policies and systems. He oversaw a sweeping reform, intended to improve accountability and efficiency, of Medicare’s administrative structure for paying claims. In 2006-2007, he served as Acting Director of the CMM.
Since joining Arnold & Porter Kay Scholer in 2008, Dr. Gustafson has advised health-care providers, device and pharmaceutical manufacturers, and trade associations on a wide array of issues, including physician, outpatient hospital and end-stage renal disease reimbursement systems; accountable care organizations; laboratory coverage, coding and payment; and launch and reimbursement issues for devices and pharmaceuticals.
A native of Maine, he is a graduate of Williams College and holds a Ph.D. in Economics from Yale University.