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In Virginia, He's an Addict. In New York, He's Treating Them

— "They keep it all very quiet. It's not part of the public record"

MedpageToday

The medical career of Larry Bruni, MD, started off with promise.

In 1992, he was as an openly gay doctor known for an aggressive treatment style in treating HIV patients, including prescribing drugs that weren't proven to work.

Bruni had became the go-to guy in Washington, D.C., for HIV patients who wanted to put up a fight. "The most aggressive doctor in town," according to a 1995 .

By the mid-1990s, things started to change.

A few of Bruni's side business ventures had gone awry, propelling his practice into bankruptcy. He lost a -- despite not having the virus.

In the early 2000s, his office billed Medicare for fake services, according to a U.S. Department of Justice news release. He had billed for injections of the clot-busting drug reteplase, usually only given to patients having a heart attack, but the DOJ said none of Bruni's patients ever got the shots.

Bruni ended up being and was sentenced to 5 months in prison in 2007. He also had to pay back $155,000 to Medicare. The DOJ said Bruni had used the money to buy things for himself and his medical practice.

When Virginia learned of Bruni's conviction, it .

State records there of mental health and substance abuse issues, including post-traumatic stress disorder, anxiety and depression, abuse of cocaine and alcohol, and opioid addiction. Bruni had spent time in psychiatric hospitals, both voluntarily and involuntarily, those records show.

One filing says Bruni admitted his addictions were so severe that he found himself unable to recall the problems his patients were facing.

In March 2014, an evaluator found deficiencies in Bruni's clinical competency: "The evaluators reported that Dr. Bruni's medical knowledge was broad, lacked depth, and was often out of date; his clinical judgment and reasoning were inadequate," state documents reported. The board allowed him to practice only under a mentoring physician.

In July 2014, he was awarded a New York license.

By January 2015, his with certain terms and conditions. A year later, Bruni again had an unrestricted license to practice in the state, although documents detailing his full history of problems is available on a state website.

These days, Bruni practices in New York, where he treats patients with opioid addictions. He has never faced any disciplinary action in the state.

His does list three disciplinary dates in Virginia in 2012, 2015, and 2016. For each record, it has a two-word summary: "No misconduct."

Bruni said he doesn't shy away from his past with patients, often bringing it up with them so they know he isn't being judgmental about their situation.

He said he's not sure how New York dealt with his disciplinary history.

"It's almost a certainty that they communicated behind the scenes with Virginia about my record," he said. "But I don't know that for a fact."

He said he doesn't think it's necessary for New York to make his past problems public. It might be different if he had harmed patients, he said, but in his case he was really only hurting himself.

In Virginia, he said, "The medical board was always clear that their mission was to protect the consumers."

"In New York they keep it all very quiet. It's not part of the public record."