Medical board charges Medicare's top physician

Baltimore doctor accused of repeated lies about credits for continuing education

April 09, 2005|By Julie Bell and Fred Schulte | Julie Bell and Fred Schulte,SUN STAFF

When Medicare chief Thomas Scully announced the appointment of Dr. Sean R. Tunis as the federal agency's chief medical officer two years ago, he lauded the Baltimore physician as a man of "excellent judgment."

Now, questions of judgment are at the heart of charges pending against Tunis before the Maryland Board of Physicians. The charges put at risk both his license to practice medicine and his job helping oversee Medicare coverage and quality.

The charges allege that Tunis lied repeatedly to Mercy Medical Center in Baltimore, falsely claiming that he had completed the continuing medical education required to renew his privileges as a moonlighting physician there.

Then, the charging documents say, he failed to cooperate when the Board of Physicians began to investigate him after it received a tip about his credentials.

Tunis said in a brief interview last night that any errors in continuing medical education logs he filed with Mercy involved lapses of memory and sloppiness in documenting which meetings he had attended - and not intentional deceit.

"When I completed those logs ... I was not referring back to my records," he said. That, he said, could account for why he was never registered for some continuing medical education meetings he said he had completed.

Tunis faces a hearing in July before an administrative law judge, who will make recommendations to the board. The board could reprimand him, place his medical license on probation or suspend or revoke it. The process could take months.

The Centers for Medicare & Medicaid Services put Tunis on administrative leave Thursday. Meanwhile, Dr. Barry Straube, chief medical officer in Medicare's San Francisco region, will take over Tunis' job on an acting basis beginning Monday, according to Gary Karr, spokesman for Medicare & Medicaid.

Tunis' job carries two responsibilities: He is both chief medical officer and director of the Office of Clinical Standards and Quality at the agency. In the first, he plays a key role in determining what new medical procedures the government should cover. In the second, he oversees efforts to set quality standards for both Medicare, which covers the elderly, and Medicaid, which provides health care to the poor and disabled.

Tunis won't be scheduled to work at Mercy until after the Board of Physicians renders a decision on his license. At that time, the hospital will decide on his privileges, Mercy spokesman Dan Collins said.

Tunis worked 30 to 40 hours a year in the urgent care area, where patients are treated for cuts, bruises and other minor injuries, Collins said. Mercy's correspondence with the Board of Physicians indicates that he worked as a clinical preceptor, teaching medical residents.

The board began looking into Tunis' continuing medical education claims after receiving a written, anonymous tip in July 2002. At the time, Tunis was trying to document at least 50 continuing medical education credit hours, according to charging documents. The credits were required for renewal of his privileges at Mercy.

The tipster alleged that Tunis had used government supplies to alter two continuing medical education certificates in January 2002. Tunis then faxed the certificates from his Medicare & Medicaid office to Mercy, the tipster alleged. At the time, Tunis was director of the agency's coverage and analysis group, the charging documents said.

An investigation revealed that Mercy's credentials file for Tunis contained two faxed copies of certificates that purported to be from organizations that conducted medical education events. But one certificate used the wrong name for the sponsoring organization, the charging documents alleged. The other certificate allegedly said he had completed 28 hours of continuing medical education, when the sponsoring organization's records showed he had completed just 14.75.

Tunis filled out logs in 1998 and 2000 attesting that he had completed the required credits needed to renew his privileges, but the logs contained various problems, the charges allege.

For example, the charging documents said, Tunis claimed to have attended meetings for which he did not register, and sometimes recorded the wrong cities for the meetings.

In another instance, the documents say Tunis claimed to have attended weekly grand rounds at Johns Hopkins from September 1997 through September 1999. But the charging documents say information obtained from Hopkins indicated that Tunis neither completed sign-in sheets for the educational rounds at Hopkins during that period nor registered to obtain certification for those credits.

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