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In late 2020, St. Peter’s Hospital in Helena fired its oncologist, Dr. Thomas C. Weiner, and took the extraordinary step of publicly accusing him of hurting patients. The hospital said the doctor overprescribed narcotics and gave chemotherapy to patients who didn’t have cancer, among other allegations.

Despite being notified by St. Peter’s that it had revoked Weiner’s privileges, the Montana Board of Medical Examiners renewed his license in 2021 and 2023. This week, the board renewed his license again for another two years.

Questions about whether Weiner would be permitted to continue practicing medicine intensified after a December ProPublica investigation exposed a trail of patient harm and at least 10 suspicious deaths tied to his practice. That investigation, which relied on thousands of pages of court records and dozens of interviews, detailed how Weiner built a high-volume business that billed as much as possible to public and private insurance while many of his patients received unnecessary, dangerous or substandard care.

While it’s unclear what the medical board considered before renewing Weiner’s license, the investigation published by ProPublica and Montana Free Press caught the attention of law enforcement. Criminal investigators with the Montana Department of Justice launched an official inquiry this month, according to three sources directly involved in the matter.

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Hailed as a savior upon his arrival in Helena, Dr. Thomas C. Weiner became a favorite of patients and his hospital’s highest earner. As the myth surrounding the high-profile oncologist grew, so did the trail of patient harm and suspicious deaths.

Weiner has denied mistreating his patients. He did not respond to a request for comment about his license being renewed and the Montana Department of Justice investigation.

After St. Peter’s fired Weiner, he sued the hospital for wrongful termination and defamation. After a four-year legal battle, the Montana Supreme Court sided with the hospital in a ruling this month. The court wrote that the hospital’s peer-review process leading to Weiner’s dismissal was “reasonable and warranted due to the quantity and severity of Weiner’s inappropriate patient care.”

After it fired Weiner, the hospital inspected the files of more than 2,000 patients to whom he had prescribed controlled substances. Court records show that medical reviewers hired by St. Peter’s highlighted the case of Sharon Dibble, a 75-year-old patient who died shortly after Weiner doubled her morphine prescription. That increase in morphine “led to respiratory arrest and the patient’s demise,” a medical expert hired by St. Peter’s concluded.

Dibble’s son, Tom Stevison, called the medical board’s decision to renew Weiner’s license “ridiculous.”

“There’s just too much evidence against him, pointing to wrongdoing, to recklessly relicense this guy,” he said, referring to the hospital’s allegations and ProPublica’s reporting. “I do believe he should be held accountable.”

Weiner previously denied the allegation that he overprescribed patients, including Dibble, and was critical of the medical review.

In the months after Weiner was fired, thousands of friends and former patients formed Facebook groups in support of him. They raised funds to rent a billboard in Helena that read, “WE STAND WITH DR. WEINER.” On Tuesday, Dayna Schwartz, who led that effort, posted on Facebook, “Congrats Doc on your license renewal!!”

A spokesperson for the state Board of Medical Examiners referred a request for comment about Weiner’s license renewal to its umbrella agency, the Montana Department of Labor and Industry. An agency spokesperson did not respond to questions before publication.

St. Peter’s did not respond to requests for comment on the renewal of Weiner’s license.

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The medical board does not typically release information about current or past investigations unless it substantiates allegations of professional misconduct. If it does, a doctor’s license can be suspended or revoked for many reasons, including billing fraud, unprofessional prescribing practices and failure to appropriately document patient care.

The criminal inquiry, led by the Montana Attorney General’s Office, comes just months after the federal government settled with St. Peter’s for making false claims when it billed government health programs for Weiner’s services. The hospital agreed to pay back $10.8 million. The hospital has previously said it provides quality care and “this situation is isolated to a single, former physician, and we remain confident in the exceptional care provided by St. Peter’s medical staff.”

Federal prosecutors also sued Weiner, accusing him of an array of fraudulent practices, including billing federal insurance programs for unnecessary treatments or more expensive treatments than were delivered. Weiner has denied the allegations and, through attorneys, has moved to dismiss the case.

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Mara Silvers is the managing editor at Montana Free Press, where she has covered health policy, social services, politics and the judiciary since 2020. She was a 2023 data fellow with the USC Annenberg Center for Health Journalism, where she reported on racial disparities in Montana foster care. Mara has also helped produce and report audio projects for MTFP, including The Session and Shared State. Prior to MTFP, Mara was a radio and podcast producer for Slate, WNYC and Montana Public Radio. Her work has been featured in ProPublica, The Guardian and NPR. She lives in Helena, where she was born...

J. David McSwane is a reporter in ProPublica’s Washington, D.C., office covering health care, energy, federal contracts and land issues.