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.

Black-market value of your health information

To adapt to our increasingly just-in-time lives the Canadian health-care system is on an upward trajectory toward digitization. This necessary modernization of health care means better patient outcomes as well as improved insight into future health-care decisions.

Despite the personal and system-wide benefits of a more digital health-care system, what cannot be ignored is that your health information has value to you, but also to people wishing to take advantage or use the information inappropriately.

The fact remains that Canadians may also be unwittingly sharing their health information. Whether it’s apps that are used, mailing lists that are joined, or online surveys, what’s really being tracked is personal health information that tells unscrupulous users information you may not want them to know. If the fine print in the privacy agreement isn’t read and understood, it’s hard to know where your information goes and how it’s used. “Every time you give a little bit away you’re putting yourself at risk.”

Read more at Lethbridge Herald

Pharmacist sentenced for fraudulent PharmaCare claims that benefited low-income patients

Jin Tong (Tom) Li of Richmond receives 12-month conditional sentence after guilty plea

A Richmond pharmacist who submitted thousands of fraudulent claims to B.C.’s PharmaCare system, mainly to save money for his poor and elderly clients, has been sentenced to a year of house arrest.

Jin Tong (Tom) Li, 41, pleaded guilty this week to one charge of obtaining more than $5,000 under a false pretense.

That crime can carry a sentence of up to 10 years in prison, but Provincial Court Judge Georgia Docolas said the 12-month conditional sentence recommended by Crown and defence lawyers was more appropriate.

“This is what I will describe as a low-sophistication crime, committed primarily to benefit his low-income, senior patients,” Docolas said Wednesday.

Nonetheless, she added, Li’s actions have had a serious impact.

“Any time there is a breach of trust involving a public body like PharmaCare … the impact is high because it affects all British Columbians,” the judge said.

Li sold his house to pay back the more than $616,000 he owed the province, the judge said, and he and his wife have had to move in with family. Li is now a stay-at-home dad to their three children while his wife had to go back to school so she could find a job to support the family.

Read the full article at CBC News.

Health minister says ‘action’ is needed but vague on how to stop crooked pharmacists

Ontario Minister of Health and Long-Term Care Christine Elliott said Thursday that she is “aware” of the pharmacy fraud brought to light in a Global News/Toronto Star investigation, adding: “It is something that I take very seriously.”

The investigation exposed pharmacists who are overbilling the Ontario Drug Benefit Program (ODB) and, at times, pocketing hundreds of thousands, — if not millions — of dollars.

“We want to know what’s happening and then what steps need to be taken by the College (of Pharmacists) or by the ministry so it’s probably going to be on both sides that action will need to be taken,” said Elliott.

When asked what steps might be taken, Elliott was vague on details.

The Office of the Auditor General of Ontario has previously called out the ministry on four occasions for having too few inspectors.

“There are 4,200 pharmacies; they only inspect about six per cent a year,” said current auditor general Bonnie Lysyk in an interview. “There’s more money to be recovered.”

“That might be one of the solutions,” said Elliott. “We’re still discussing the situation with the ministry.”

Lysyk said the AG report identified $3.9 million in 2015-16 in inappropriate payments made to pharmacists through the ODB, including $900,000 in billings related to prescriptions being filled for deceased people.

Read the full article at Global News

Pharmacy fraud is costing us millions. Why won’t Ontario take it more seriously?

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

Ontario failing to recover millions in fraudulent OHIP billings by doctors

Ontario’s Ministry of Health is doing little to crack down on doctors who improperly bill OHIP, according to information obtained by CBC/Radio-Canada. 

A freedom of information request shows the province has recovered only $1.1 million in illegitimate billings over the past two years, while the auditor general pointed in her 2016 report to some $6 million in fees improperly paid to doctors. 

“This is a complete waste of taxpayers’ money, taxpayers’ money that was supposed to go to health,” said NDP health critic France Gélinas in an interview with CBC News. 

“It is incomprehensible that when the government sees those kinds of mistakes, that they don’t recoup the money,” Gélinas said.

This suggests little has changed since 2016, when Auditor General Bonnie Lysyk criticized the health ministry for inadequately investigating fraudulent billing and for failing to follow up on physicians with a record of charging  inappropriate fees to OHIP.

“The ministry lacks effective enforcement mechanisms to recover inappropriate payments from physicians,” Lysyk wrote in her 2016 report. “Unless a physician agrees to repay amounts voluntarily, it is very difficult to recover inappropriate payments.”

Read the full article at CBC News

 

Expert warns of incarcerating people with intellectual disabilities in psychiatric wards

The author of a study that sounded an alarm over confining Nova Scotians with intellectual disabilities in a psychiatric ward has testified the “incarcerated” residents were denied their human rights and good care practices.

Dorothy Griffiths gave her evidence via video conference last week at a human rights inquiry considering whether the human rights of Joey Delaney, Beth MacLean and the late Sheila Livingstone were violated by confining them in psychiatric wards or hospital-like settings rather than a home in the community with appropriate care.

Read more at The Globe and Mail

Durham families share long-term care horror stories with Ontario NDP leader

OSHAWA — NDP Leader Andrea Horwath has added local stories of struggle with long-term care to her growing list of concerns about Ontario’s long-term care system.

Along with Oshawa MPP Jennifer French, Horwath recently met with three Durham families who discussed their difficulties in accessing quality long-term care for loved ones.

Read more at Durham Region News

Grey Matters: Seniors shouldn’t quietly take their medicine

When it comes to pharmaceuticals, seniors tend to be super users. Two-thirds of those in long-term care facilities take 10 or more medications, according to a 2012 Canadian Institute for Health Information (CIHI) report.

Even among active older Canadians, pharmaceutical use is high. A poll of 5,190 CARP members in July revealed that, while 10 per cent use no prescription medications, CARP members are prescribed four medications each on average and five per cent take 10 or more.

Read more at National Post

Texas School Beats ADHD by Tripling Recess Time

While most school districts across the country are cutting back on recess time and ramping up the Ritalin, one Texas school has kindergartners and first graders sitting still and “incredibly attentive.”

What’s their secret? Their recess time has tripled.

Instead of 20 minutes of recess per day, Eagle Mountain Elementary kindergartners and first graders now get an hour, broken up into four 15-minute breaks, in addition to lunchtime.

Their teachers say it’s totally transformed them.

Read more at Return To Now

Our view: Erie County right to sue Big Pharma

At the recent Erie Times-News/GoErie.com opioid forum at Mercyhurst University, a grieving mother waited long with her hand raised, before finally standing to have her question heard.

When, she wanted to know, would drug dealers be brought to justice?

This has been a difficult piece of Erie County’s response to the opioid addiction and overdose crisis that in 2017 alone has taken more than 100 lives.

Read more at The Times