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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.

Doctors propose plan to reveal top OHIP billers

Ontario patients may soon learn how much some of the province’s highest billing doctors receive in taxpayer-funded OHIP payments.

If the Ontario Medical Association follows through on a proposal from some of its members, it would assist in publicly releasing the names of some top-billers, a move that would mark a dramatic reversal in its position that such disclosure would be a violation of personal privacy.

Doctors have been discussing the plan for more than a week on a social media site, the Star has learned.

Read more at Toronto Star

Texas doctor slapped with 35-year sentence and $268M in restitution for massive fraud scheme

A 60-year-old Dallas-area doctor will spend decades in prison and pay more than $268 million dollars in restitution after being convicted of conspiracy and healthcare fraud charges as well as obstruction of justice for a scheme that bilked Medicare and Medicaid for hundreds of million of dollars.

For what the Department of Justice called a “large-scale, sophisticated healthcare fraud scheme,” physician Jacques Roy, was sentenced last week to 35 years in prison along with the hefty restitution penalty, for conspiring with several co-defendants to defraud Medicare and Medicaid through companies they owned, including Medistat Group Associates, Apple of Your Eye Health Care Services, Ultimate Care Home Health Services and Charry Home Care Services.

Read more at Healthcare Finance

Arnprior doctor, hospital sued in $5-million malpractice claim

When Ray Nicholas noticed a bump on his stomach, he went to see his family doctor and was advised it was likely a hernia, and that there was no need for treatment.

A month later, in July 2015, he returned to the doctor, complaining of pain. He says he was told to keep rubbing and pushing it in to alleviate the discomfort.

No medication prescribed, no referral to a specialist.

A month after that, Nicholas needed life-saving surgery.

Read more at Ottawa Citizen

Psych center employee charged with abuse, fraud

MARCY — An employee at the Central New York Psychiatric Center has been charged with defrauding Workers’ Compensation after law enforcement officials said he was caught kayaking on a Caribbean vacation.

Ryan P. Haley, 30, of Rome, unlawfully received more than $2,500 from the state Workers’ Compensation while on pre-planned vacations to Puerto Rico and California, according to the state Inspector General. Haley also physically harassed a Psych Center patient after he returned to work, officials said.

Haley is a security hospital treatment assistant at the Pysch Center, officials said.

Read more at Rome Sentinel

Washington Declares War on Opioid Epidemic, Fraudulent Doctors

The US war on the opioid epidemic is heating up, with 3 recent noteworthy developments.

On July 31, Chris Christie, chair of the President’s Commission on Combating Drug Addiction and the Opioid Crisis, issued his interim report, calling the recommendation to declare the opioid epidemic a national emergency the most important of all.  (Among the other recommendations: mandating physician education, increasing availability of the overdose reversal agent naloxone).1

Read more at Practical Pain Management

Insurers Think They’ve Found the Perfect Patients for Profits

The turmoil around the Affordable Care Act has created heartburn for health insurers. The industry is betting that a different government program will soothe its ills.

Big insurers have retreated from Obamacare’s individual market, where fighting over the future of the health law has contributed to financial losses. They’re focusing instead on Medicare Advantage, a politically popular program that’s being embraced by a growing population of older Americans.

Read more at Bloomberg

Hoskins will ‘express concerns’ about patient record software being used to sell drugs

Concerned for patients’ privacy and pocketbooks, Ontario’s health minister says he will tackle a new Big Pharma marketing scheme that uses electronic medical records to sell drugs.

Minister Eric Hoskins said he will ask Ontario’s College of Physicians and Surgeons to investigate how electronic vouchers that steer patients to brand name drugs over cheaper generics “may be impacting privacy, accessibility and affordability.”

He said he also plans to “express my concerns” with Telus Health, which inserts the electronic vouchers into its popular electronic medical record software (EMR) used by thousands of doctors across Canada.

Read more at The Toronto Star

Canadians’ health-care costs have skyrocketed: Study

TORONTO – Health-care costs for the average Canadian family have increased by nearly 70% during the last two decades, a new Fraser Institute report says.

The study, which used data from Statistics Canada and the Canadian Institute for Health Information, says the typical Canadian family of four will pay $12,057 for health care in 2017.

Read more at Toronto Sun

Publicly funded opioid prescriptions increase, despite addiction risk

Doctors are prescribing more opioids to vulnerable people in three Atlantic Canadian provinces, despite years of warnings about the addictive prescription painkillers.

The number of publicly funded prescriptions for opioids increased by 26 per cent between 2010 and 2015, according to data compiled by the Canadian Institute for Health Information for CBC News.

Read more at CBC News

Ottawa pushed to prosecute Purdue Pharma over ‘deceptive’ marketing of OxyContin

The harms to individuals, health-care systems and society from Canada’s opioid crisis are so grave that some physicians and lawyers are calling for criminal prosecution of OxyContin’s drugmaker.

As part of a Canada-wide settlement announced in May following a class-action lawsuit, Purdue Pharma (Canada) agreed to pay $20 million — including $2 million to provincial health plans — over how the company marketed and sold its pain medications OxyContin and OxyNEO.

Read more at CBC News