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

August 21, 2018

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…

Filed Under: Health Fraud Series, Healthcare Fraud Tagged With: 10, Canada, canadian, care, facts, fraud, health, healthcare, money, shocking, stolen

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

August 8, 2018

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.

Filed Under: Health Fraud Series, Healthcare Fraud Tagged With: canadian, canda, care, fraud, health, money, steal, stolen

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