Monitor Telegram

Bringing about a higher level of transparency and accountability in provincial and federal governments to help protect taxpayers from abuse

Bringing about a higher level of transparency and accountability in provincial and federal governments to help protect taxpayers from abuse.

Canada Invests in Next-Generation Smart Grid Technology

Transforming how we make and use energy presents tremendous economic opportunities for Canada and will result in investments, good middle-class jobs for Canadians and a cleaner planet for future generations.

Today, Canada’s Minister of Natural Resources, the Honourable Amarjeet Sohi, announced an investment of $1.4 million for a next-generation smart grid project. Funded by Natural Resources Canada through the Green Infrastructure Program and developed by ENMAX Power, this project will safely send extra renewable electricity generated by customers back into Calgary’s electricity grid for others to use.

Read more at newswire.ca

10 Shocking Facts About Canada’s Healthcare System – Part 3

Part 3. Canada Has No Interest In Fraud, Only In Spending

In the article “What you need to know about the Canada Health Transfer” of December 2016 the Globe and Mail reported “The Canada Health Transfer is the money the federal government sends to the provinces and territories to help pay for health care, which is a provincial responsibility. Ottawa can use the CHT to enforce the Canada Health Act, although, in practice, it rarely does.

The transfer can be clawed back if a province fails to uphold any of the act’s five principles:

  1. universality,
  2. comprehensiveness,
  3. portability,
  4. accessibility and
  5. public administration.

So not only is protecting taxpayers from fraud clearly not one of these five principles, there is no law enforcement unit anywhere in the federal government that exists to deal with it.  Therefore, it is clear that the feds’ health budget is practically free money.

Prime Minister Trudeau’s “health mandate” nowhere even remotely addresses the issue and the Royal Canadian Mounted Police, which is a federal agency that acts as provincial police for numerous provinces, has no health fraud mandate.  Take Saskatchewan as an example, where doctors can use any of 3500 different billings codes and which “to some extent uses the honour system,” to quote a June 2017 article by CBC News.

 

The case of Ontario

The Ontario Ministry of Health and Long-Term Care claims in their website to be “committed to detecting abuse and misuse of the Ontario health care system”.  And who, according to them, is committing the health care fraud? Persons who:

  1. knowingly use a health card that is not theirs
  2. receive OHIP services who are aware that as a non-resident of Ontario they are not eligible
  3. knowingly gives false information to the ministry to become or continue to be an insured person when they are aware that they are not eligible.

The Ministry claims that they investigate “each and every allegation it receives regarding potential health insurance fraud”.  Who do they think they’re kidding? Do they really think that tracking down someone from out of province who is using their cousin Fred’s OHIP card is going to put any kind of dent in the enormous health care fraud bill that taxpayers bear?  The ministry makes NO mention of investigating fraud perpetrated by practitioners. There isn’t even a hint of it.

 

Hindering law enforcement

Ontario, unlike many of the other provinces, at least has established a police unit charged with the detection, investigation and pursuit of health care fraud.  The Anti-Rackets Branch of the OPP (Ontario Provincial Police) has a Health Fraud Investigation Unit, comprised of 19 officers. But as noted in part 2 of our series, the Ministry has been very lax in forwarding suspected fraud cases to the OPP’s Health Fraud Investigation Unit.  

In fact, after waiting in vain for years for the Ministry to send them some cases to investigate, this police unit had to contact the Ministry and ask that they send some.  And what did the Ministry send them? The Unit received 13 cases, eight of which were considered as being too old to investigate. The Ministry stepped up their game in 2016-2017, reporting six cases of possible billing fraud to the OPP, but did not follow up to see whether charges had been laid or the practitioner convicted.  The police, who will vigorously investigate suspected fraud, are being sabotaged by the Ministry.

And even when the officers uncover medical fraud and charge the perpetrators, the sentences are often so light as to be meaningless.

And did you know that pharmacists and doctors convicted of OHIP fraud are very rarely stripped of their licenses to practice by the Colleges that supposedly regulate these professions?  Furthermore, did you know that doctors charged by the police with committing fraud are defended in court by high-priced lawyers that you pay for? Don’t believe it?

This is one of a 10-part series.  Stay tuned for Part 4, coming soon!

Edmonton could set four-bag garbage limit by 2020

An overhaul of the city’s waste-management system could, if approved by council, represent the biggest shift Edmontonians have seen in the past 20 years.

Though more than a year away, the changes would require residents to separate organics from other trash, and would restrict the amount of garbage that could be set out on the curb.

The shift would move Edmonton from a two-stream to a three-stream waste system by 2020.

Read more at cbc.ca

Stop producing nuclear waste until we can dispose of it, critics urge Canada

Environmental groups say Canada should stop producing nuclear energy until the federal government replaces its “pathetic” waste disposal policy with something more meaningful and scientific.

The groups, including the Canadian Coalition for Nuclear Responsibility and the Canadian Environmental Law Association, intend to protest outside a meeting Wednesday where officials will discuss plans to decommission nuclear labs and reactors in Chalk River, Ont., and Pinawa, Man.

Read more at cbc.ca

10 Shocking Facts About Canada’s Healthcare System – Part 4.

Part 4. When Doctors Are Charged, You Pay Their Legal Bills!

 

When celebrities like OJ Simpson are accused of a crime they are responsible for paying their legal bills.  When mobster Al Capone was arrested in 1931 he had to pay for his legal defense. So did Conrad Black. And Alan Eagleson.  This is the case for everyone. Right?

 

Wrong.  If you are a doctor in Canada you enjoy legal protection of the highest caliber, funded by the taxpayers!

 

In September 2015 the Toronto Star published a scathing indictment of a secretive and largely unknown organization, the Canadian Medical Protective Association (CMPA).  Their article was entitled “Suing a doctor? Your tax dollars will be used against you: Canadian physicians are backed by $3.2-billion war chest indirectly funded in part with public money.”  

 

“Following a medical procedure, you find yourself suffering from a serious, unexpected health issue you believe was caused by negligence.  You decide to sue your doctor for pain, suffering, loss of income and the costs of care. Here’s what you may not know: you won’t just have to pay your own lawyer. Your tax dollars will finance top-flight lawyers to vigorously defend your doctor and challenge your claims.”

 

Yes, readers, that’s right.  The CMPA is a publicly funded defense organization for doctors accused of wrongdoing.  Doctors pay fees to the CMPA and then are reimbursed a hefty percentage from the public coffers, to the tune of hundreds of millions of dollars each and every year.  CMPA financial statements show their membership revenue to be $566.2 million for 2016, and that expenditure has been steadily rising well ahead of the general rate of inflation.  You paid most of that.

 

And just to add insult to injury, the egregious defense campaigns employed by the CMPA hired-gun lawyers financed out of their multi-billion dollar war chest are legendary.  CMPA lawyers are notorious for their “scorched-earth” tactics of:

 

  1. deny the doctor did anything wrong
  2. delay, delay, delay
  3. attack the plaintiff
  4. appeal, appeal, appeal

 

You should also be aware the CMPA does not provide medical malpractice insurance.  The CMPA provides high-priced lawyers to doctors. Very few doctors in Canada have actual liability insurance from bona fide insurance providers (they’d have to pay for that themselves).  Instead, they rely on the publicly funded CMPA to get them out of any scrape they find themselves in.

 

And the CMPA’s financing of a doctor’s defense is not limited to medical malpractice issues; they also fund the defense of a doctor accused of civil or criminal offenses.  Maimed a patient? Operated on the wrong body part? Slandered someone? Sexually assaulted a patient? Got nailed on a DUI? Committed OHIP fraud? Don’t worry – the CMPA lawyers are all over it.  And don’t suppose that the doctor will lose his license to practice if convicted. The Colleges of Physicians and Surgeons, those so-called regulators of MDs and protectors of public safety, are notoriously forgiving of errant, incompetent, and even criminal doctors.  

 

And here’s another disturbing fact: it doesn’t matter how many civil or criminal predicaments a doctor finds himself in – the taxpayer-funded CMPA lawyers will be there for him time after time.

 

Is it possible that you have been an unwitting and involuntary participant in healthcare fraud?  Find out in part 5 of our series…

Corruption, wasted taxpayer money has become the norm in Albany

As Sheldon Silver, the former New York State Assembly Speaker was sentenced to seven years for kickbacks, I was appalled by the state that the Albany legislative body is in today. All the corruption and wasted taxpayer dollars seems not to anger the incumbent elected officials. I know there are some that are upset, but not enough politicians are speaking out on the rampant corruption that Albany is faced with.

Read more at timesledger.com

10 Shocking Facts About Canada’s Healthcare System – Part 5.

Part 5. You May Have Been Unwittingly Been Involved In A Fraud Scheme

Here’s an all-too-common scenario in Canada, based on one story of an actual patient.  

This was a 55-year old man who was experiencing problems with his knee.  The family doctor referred him to a specialist in a hospital, but when the patient arrived at the hospital some weeks later he discovered that he was scheduled for a series of tests that had nothing to do with his knee.  This included a colonoscopy, among other procedures. Alarmed, he told the doctor’s receptionist that he was surprised that this has happened, as he had been expecting his knee to be looked at, and he refused all the tests.  At this point the receptionist started whispering that happened all the time at that facility, and that many administrative staff and nurses were upset about all the unnecessary treatments – especially since it was taxpayers that were billed for it.  Billing for unnecessary services is fraud.

Apparently, it’s possible for you to be treated by a doctor who isn’t even in the country.  ISB Canada has found cases of physicians billing for services supposedly provided at their local treatment facilities while the doctors were actually overseas!

Have you ever been treated by someone other than a physician such as a nurse or a nurse practitioner?  Well, there have been cases where patients were treated by such personnel, yet the treatment was billed as having been performed by a doctor because the rate is higher for doctors.  There have even been cases where the treating personnel weren’t even qualified to see patients in any capacity. One psychological care facility hired “therapists” who had had no training in the area, and at least one of these bogus “therapists” was hired because he was a friend of the facility’s owner.

Then there was the case of a psychological facility that had a group of unsupervised patients watching a movie that the facility then billed as “group therapy”.

Believe it or not, you don’t even have to be alive to be unwittingly involved in a fraudulent scheme.  TVO reports that the Auditor General’s office found $951,900 had been billed and paid out for prescriptions for people who had already passed away.  And that was in one year alone (2015-2016).

You may also have received services that you don’t even know about.

In a recent case in Ontario, a doctor falsely submitted claims for a patient’s non-existent conditions.  As a result of these imaginary conditions being entered into her medical records, she was unable to get private travel insurance.  When she discovered the falsification and asked OHIP to remove the false information from her file, they wouldn’t do it because payments for the procedures had already been made.  The patient sued the doctor and one of the doctor’s former employees for fraud.

In one Ontario case, a doctor had labeled many of his patients as having a mental problem and billed the Ontario Health Insurance Plan (OHIP) for these supposed illnesses.  The patients knew nothing of this.

Can you imagine going in for a foot problem and getting labeled schizophrenic?  Your future is altered and not for the good, and the doctor gets paid by OHIP for it – even though it’s false.  Worse still, OHIP might not correct your records!

There are many, many other scenarios you can watch out for.  One common example is “unbundling.” In this scheme, a practitioner or a facility takes a bundle of services that are commonly delivered together, and are bundled by the insurance provider at a discounted rate, and bill for the services separately for a higher total rate.  

So, just how many ways are there that dishonest practitioners can use to steal money from us?  Find out in part 6 of our 10-part series.

 

Parliament Hill rink wins dubious award for waste of taxpayer dollars

The $8.2 million temporary outdoor skating rink built on Parliament Hill to celebrate Canada 150 won the well-known Teddy Awards for government waste this year.

A brainchild of the Department of Canadian Heritage, the structure topped the ranks of the federal government nominees for the dubious prize. The rink, which opened in early December and will remain open until the end of February, will have cost taxpayers approximately $100,000 per day and $53 per skater, calculates the Canadian Taxpayers Federation, which organizes the annual Teddy Waste Awards.

Read more at globalnews.ca

Android 9 Pie rolls out with new tools to fight tech addiction: Here’s everything you need to know

Google released the latest version of its mobile operating system Android on Monday, and the new software includes a series of substantial changes.

Android 9 Pie boasts a machine learning-powered system to save battery power, a new gesture-based navigation tool and features to track how much time you spend on your phone.

Read more at telegraph.co.uk

10 Shocking Facts About Canada’s Healthcare System – Part 6.

Part 6. They Have More Ways To Steal Than You Can Dream Of!

Paul Jesilow, Department of Criminology at the University of California and Bryan Burton, Department of Political Science and Criminal Justice at Southern Utah University specify that:

“Healthcare fraud involves wide-ranging illegal behaviors. It includes such activities as individual physicians who bill insurance companies or the government for services that were never provided, as well as corporate behavior, such as pharmaceutical companies that falsify clinical tests in order to get unsafe drugs approved for use. Thousands die each year in the United States due to these behaviors, including deaths from incorrectly prescribed medications or from tainted drugs that were approved by the U.S. Food and Drug Administration based upon fraudulent testing and reporting. Thousands of additional patients likely are injured and killed by unnecessary surgeries performed by physicians who want to maximize their reimbursements. The illegal activities also add billions of dollars each year to the total healthcare cost in the U.S. Despite these costs, there is relatively little outrage as a result of the behaviors, largely because they remain hidden from public view.”

One of the greatest scams in Canadian history involved Ontario and Alberta paying hundreds of millions of dollars to American hospital chains to treat people for addiction.  The hospitals had hired “bounty hunters” who picked up people off the street in Canada to send to these facilities. The “patients” were promised a vacation at taxpayer expense and when they got to the U.S., their “treatment” often consisted of barbeques with hamburgers and hot dogs.  They returned in whatever condition they left, and the government paid $150,000 for each of them. And although it was widely exposed in the media, the government did everything in its power to squash the issue. The money was never recovered from the American hospital chain.

In California, there was a case of a hospital that billed Medicare for more than nine years and with more than 150 beds that earned millions of dollars in fees.  There was only one problem: the hospital had never been built.

Then there were all the Ontario cases for supposed patients being treated for addiction by Methadone.  The patients billed for were street people. Their identities had been procured and were being used to bill taxpayers, but it was nothing but a scam as hundreds, if not thousands, of them did not even reside in the facilities that were doing the scamming.  Not to mention that none were ever recorded as cured.

In April 2016 it was exposed in the National Post, headline reading “Methadone doctor accused of coercing patients into using pharmacy linked to his clinic: Patients said the Brantford doctor threatened to cut off their take-home doses and physically walked them into the store, according to a disciplinary ruling.”

Then there are:

  1. Billing for “phantom patients”
  2. Billing for fabricated conditions
  3. Billing for medical goods or services that were not provided
  4. Billing for more hours than there are in a day
  5. Paying or receiving a “kickback” in exchange for a referral for medical goods or services
  6. Concealing ownership in a related company
  7. Using false credentials
  8. Double-billing for healthcare goods or services not provided
  9. Billing for a non-covered service as though it were a covered service
  10. Misrepresenting the provider of the service
  11. Dispensing a lower-cost drug and billing for the higher-cost one
  12. False or unnecessary issuance of prescription drugs
  13. Billing for drugs never dispensed
  14. Unnecessary surgery and other procedures
  15. And several hundred more

How is it even possible that this magnitude of fraud can occur?  Is it difficult or even impossible to detect? Emphatically, no. Keep reading – we cover that in part 7 of our series.