A cancer doctor who worked from 1993 until 2011 at a Kansas medical practice owned by approximately seventy physicians, and now works at another physician-owned cancer center in Wichita, Kansas, was the subject of internal audits beginning in 2010 that addressed whether the oncologist treated some patients for cancer that they did not have, and if the doctor unnecessarily and inappropriately treated other cancer patients. The results of the audits that were conducted in 2010 and 2011 were disturbing, to say the least.
The audit of 104 randomly selected patient charts for patients treated by the doctor reportedly found evidence to question the competency of the oncologist in his treatment of some cancers, including findings that the doctor failed to follow established national cancer treatment guidelines in 40% of the charts reviewed; that the doctor unnecessarily and “often too early, too much, and too long” treated some patients who had lymphoma and blood cancers; that he frequently split doses of chemotherapy and other medications without documenting his reasoning; and, that he overprescribed support IV therapies and gave patients with blood cancer an excess number of bone marrow tests, which the auditor stated may be interpreted as Medicare fraud.
Dose Splitting Allegations
Dose splitting is where a doctor splits the dosage of chemotherapy (or other drugs) and administers the drugs over a period of days or weeks instead of giving the entire dose at one time. There may be legitimate reasons for dose splitting, such as when a patient cannot tolerate the entire dose at one time. However, the doctor’s rationale for dose splitting should be documented in the patient’s chart.
Engaging in dose splitting when it is not appropriate or justified results in physicians billing Medicare (or other health insurance) for additional treatments and in physicians receiving additional reimbursement to which they are not entitled (Medicare reimburses physicians per service and pays for administration of chemotherapy by the hour). Dose splitting may also result in dilution to the point that it becomes ineffective.
The auditor stated, “The high frequency for choosing the day 1-8 fractionation scheme suggests a rationale in [the doctor’s] mind other [than] patient-specific factors such as a suspected intolerance to the recommended and conventional way of dosing these medications. The rationale [the doctor] has in mind is never in the medical records of these patients.”
A 2010 internal document from the outside auditor stated, “[The doctor’s] decade-long solo practice created a ‘god-like’ status where mid-level providers and nurses did not question his practice style and this atmosphere still creates difficulty. [The doctor’s] practice includes the off-label use of oncology drugs and non-evidence based dosing and schedule variation.” The auditor recommended that the oncologist should not be allowed to treat certain cancer patients or he should become Board-certified in the required area. (An audit of the other oncologist who worked at the same medical practice found no compliance issues.)
If you or a loved one may have a claim against a cancer doctor (an oncologist), you should promptly consult with a local medical malpractice attorney in your state who may investigate your cancer claim for you and represent you in a cancer medical malpractice case, if appropriate.
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