ANALYSIS: Pharmacists cheat the system to the tune of more than $100 million each year — and the province is doing little to stop them, writes Josh Dehaas
There’s a way to pump millions of dollars into Ontario’s health-care system without raising taxes. All it requires is that the province take the abuse of its public drug plans more seriously.
Karen Voin, who works in fraud prevention for the Canadian Life and Health Insurance Association, says the industry believes that between 2 and 10 per cent of all health-care dollars are lost to fraud.
Even if you take the conservative estimate — 2 per cent — and apply it to Ontario’s $5.9-billion public drug plan system, it works out to $118 million lost each year. That figure will only rise, given that the province now offers free prescription drugs to people 24 and under.
Yet the Ministry of Health and Long-Term Care is recovering only about $5 million per year from its pharmacy inspections, according to a report released last month by Auditor General Bonnie Lysyk. That includes not only fake billing, but also money paid out by the ministry in error.
Most alarming is that when the province does find potential fraud, it don’t always inform police in a timely fashion — or make sure the money is paid back. And the Ontario College of Pharmacists, the self-regulator, doesn’t always take licences from those who abuse the system.
Put it all together, and it’s clear that not enough is being done to detect and deter fraudsters.
Read the full article at tvo.org