Two months after the Maryland Board of Physicians suspended his license for falsifying documents, Sean R. Tunis remains on the federal payroll as a high-ranking official at the Centers for Medicare and Medicaid Services.

In late May, Tunis agreed to the one-year suspension and a $20,000 fine for submitting false records suggesting he had completed his required continuing education. Tunis, Medicare's chief medical officer and director of the Office of Clinical Standards and Quality, has been on paid administrative leave since April.

At the time, Bush administration officials said they did not plan to take any action until the Maryland board completed its investigation. CMS spokesman Gary Karr recently declined interview requests and refused to offer an explanation for why Tunis continues to be paid, saying it was a "personnel matter."

In a 15-page "charging document" filed in February, the state board accused Tunis of unprofessional conduct and making false statements about his credentials. Investigators said he falsely claimed to have completed 50 credit hours of continuing medical education and submitted altered records. Under Maryland law, physicians must complete continuing education to keep their licenses current. Often the requirements can be met by attending professional conferences, completing online courses or reviewing academic journal articles.

In a settlement agreement with the state board, Tunis attributed the falsifications to "careless record-keeping" but stressed that he had "never been the subject of any complaint related to patient care."

He added: "I decided to sign this Order because I acknowledge that I made a mistake and I wish to accept responsibility for it." The consent order also required Tunis to complete an ethics course and 35 hours of continuing medical education.

Tunis declined an interview request.

In addition to a government salary of $107,000 to $162,000 a year, Tunis has been receiving a bonus known as a physician comparability allowance, or PCA. A friend of Tunis authorized to speak anonymously on his behalf said the only requirement for receiving the allowance, estimated at $30,000 annually, is that the person be board-certified.

If a physician's license is suspended, however, the certification also would be suspended, said Cary Sennett at the American Board of Internal Medicine.

Investigators in the inspector general's office at the Department of Health and Human Services are also investigating the Tunis case.

Tunis, a graduate of Stanford University School of Medicine, was hired by the Medicare agency in 2000. In his dual posts, he held considerable sway over decisions about what therapies and medical devices would be covered by Medicare, a $333 billion program serving 42 million elderly and disabled people.

-- Ceci Connolly

Suspended: Sean R. Tunis, Medicare's chief medical officer.