HELENA, Mont. — A Montana cancer doctor for years saw up to 70 patients a day, double-billed federal health care programs and overprescribed pain medications to boost his income, the U.S. Attorney’s Office said Tuesday while announcing a civil lawsuit against him and a $10.8 million settlement with the hospital where he worked.
Dr. Thomas Weiner was fired from St. Peter’s Health in late 2020. He still has a medical license according to the state Board of Medical Examiners and has not been charged criminally. He maintains his innocence and has sued the hospital for firing him.
The four-year federal investigation found Weiner ordered medically unnecessary treatments, saw patients more often than necessary, falsified records to bill at higher amounts than allowed and prescribed painkillers to non-cancer patients, doing so “to increase his personal income, with little regard for the potential patient harm his conduct created,” according to the civil lawsuit filed Monday.
Federal prosecutors declined to comment on why criminal charges haven’t been pursued.
The hospital reported the false claims and aided in the investigation, U.S. Attorney Jesse Laslovich said. But the hospital also was paying Weiner a salary based on the false claims and referrals he made to the hospital from its Cancer Treatment Center.
Federal law does not allow physicians to be paid based on treatment referrals to affiliated hospitals. Logan Health in Kalispell, previously Kalispell Regional Healthcare System, reached a $24 million settlement in 2018 for paying specialists based on their referrals for treatment at the hospital.
St. Peter’s Health CEO Wade Johnson said he does not believe any other physicians at the hospital were engaged in filing false claims with Medicare, Medicaid and other federal programs. The settlement will be paid out of the hospital’s reserves, he said.
“St. Peter’s is ultimately responsible for maintaining compliance with federal law and our team has worked hard to ensure we have a much stronger compliance system in place,” Johnson said Tuesday.
After Weiner was fired, the hospital said it learned he had incorrectly treated a patient for cancer for 11 years and that he was engaged in “alarming narcotic prescribing practices.”
Dr. Weiner has denied all wrongdoing “and asserts that these proceedings are the result of ongoing employment litigation” with the hospital, his attorney Deanne McClung said in a statement. “We are confident that when the evidence is presented, Dr. Weiner will be exonerated.”
The civil lawsuit alleges Weiner had staff double- or triple-schedule appointments in 15-minute intervals and spent an average of four to seven minutes with each patient, giving him little time to review their patient records, document the visit or to stay up-to-date on research. Most oncologists see 15 patients or fewer per day, the lawsuit states.
“Weiner wanted this schedule because it maximized his income,” the suit states.
An audit of Weiner’s billing by the hospital in 2018 found he did not adequately document the services he was billing for, but the government said the hospital wrongly allowed him to modify his medical records to justify the bills.
Weiner also ordered unnecessary, more costly or in some cases more dangerous tests to increase his income, the lawsuit alleges.
He also prescribed a medication that can be used to help keep a cancer patient in remission for longer than medically necessary. The drug is typically given for one to two years and there were several instances of Weiner’s patients receiving the drug for 10 years or more, federal officials allege.
Weiner also used non-standardized chemotherapy treatments that are administered more frequently, were not medically necessary and may have caused harm to patients, the lawsuit said.
Weiner continued to prescribe high doses of pain medication to patients who no longer had cancer, the suit said. From August 26, 2019, through Dec. 31, 2020, Weiner wrote at least 316 prescriptions for 11 patients with no documented medical purpose.
The lawsuit seeks triple damages and civil penalties for each false claim and for the court to prevent Weiner from prescribing controlled substances for five years.
The following was sent out byU.S. Attorney’s Office, District of Montana:
U.S. Attorney for the District of Montana, Jesse Laslovich, today announced a settlement agreement between the federal government and St. Peter’s Health, in Helena, in which St. Peter’s will pay $10,844,201 to resolve allegations that it violated the False Claims Act by submitting false claims for payments to federal health care programs for services performed by an oncology doctor.
U.S. Attorney Laslovich announced the settlement agreement today during a press conference at the U.S. Attorney’s Office in the Paul G. Hatfield Federal Courthouse in Helena.
“One of the purposes of the False Claims Act is to protect the American taxpayer from paying for false claims submitted by health care providers to federal health care programs. We take these allegations seriously, which is why I am pleased we obtained this settlement agreement that returns almost $11 million to the United States. Our health care providers simply must submit accurate claims when billing these taxpayer-supported federal health care programs for services. This settlement would not have been possible without the cooperation of St. Peter’s Health, who voluntarily disclosed the misconduct and cooperated with federal investigators to identify the problem and amount of false billing,” U.S. Attorney Laslovich said.
“Today’s settlement highlights our unwavering commitment to enforcing the False Claims Act and upholding the integrity of federal health care programs,” said Special Agent in Charge Linda T. Hanley, of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “St. Peter’s submission of false claims and its associated compensation practices violated both legal and ethical standards. We will continue collaborating with our law enforcement partners to hold entities accountable, prevent similar violations, and safeguard public funds.”
“VA’s Community Care programs provide veterans and their families critical healthcare services from providers within their own communities,” said Special Agent in Charge Dimitriana Nikolov, of the Department of Veterans Affairs Office of Inspector General’s Northwest Field Office. “This civil settlement reinforces the VA OIG’s commitment to safeguarding the integrity of VA’s healthcare programs and operations and preserving taxpayer funds.”
The settlement agreement, signed on August 26, 2024, is among the U.S. Department of Justice, the Office of Inspector General of the Department of Health and Human Services, on behalf of the Medicare and Medicaid programs; the Defense Health Agency, on behalf of the TRICARE program; the Office of Personnel Management, which administers the Federal Employees Health Benefits Program (FEHBP), the U.S. Department of Veterans Affairs (VA); the Office of Inspector General of the Railroad Retirement Board (RRB) and St. Peter’s Health.
Under the terms and conditions of the settlement agreement, St. Peter’s is to pay $10,844,201 no later than 30 days after the effective date of the agreement.
The settlement agreement contends that St. Peter’s violated the False Claims Act by submitting false claims for payments to federal health care programs relating to services performed and referred by Dr. Thomas Weiner, an oncologist employed at its cancer treatment center. The government alleged that between Jan. 1, 2015 and Dec. 31, 2020, St. Peter’s, relying on Dr. Weiner’s documentation and certification, submitted claims which were determined to be false. St. Peter’s knew, or should have known, that Dr. Weiner submitted claims for office visits that were coded at a higher level of service than was actually performed or did not meet the requirements of a significant, separately identifiable service when performed on the same day as administration of chemotherapy. Further, St. Peter’s, relying on Dr. Weiner’s documentation and certification, compensated Dr. Weiner with a salary that was based on the false claims, and therefore, caused his salary to be inconsistent with fair market value.
The settlement agreement credits St. Peter’s for voluntarily self-disclosing the misconduct. St. Peter’s also performed and disclosed the results of an internal investigation; disclosed documents beyond existing business practices or legal requirements; identified individuals who were aware of relevant information or conduct; made officers and employees available for interviews; assisted in determining the losses caused by the misconduct; and has enhanced its corporate compliance program.
The U.S. Attorney’s Office’s handled the matter. The U.S. Department of Health and Human Services Office of Inspector General and U.S. Department of Veterans Affairs Office of Inspector General provided investigative support.
The claims resolved by the settlement are allegations only. There has been no determination of liability.
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Publish date : 2024-08-27 02:59:00
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