Montana doctor overprescribed meds and overbilled health care to pad his income, prosecutors say

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.