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This is why greedy pharmacists are costing taxpayers millions of dollars

March 11, 2019

This past week, Global News’ investigative team published an explosive investigation detailing how some pharmacists are making big bucks by scamming the Ontario Drug Benefit Program out of millions of dollars.

The ODB pays for medications for Ontario’s most vulnerable: children, the elderly and those on social assistance. When a qualified patient fills a prescription, they either don’t pay anything or pay a few dollars, and ODB covers the rest.

The program costs the province more than $5.4 billion a year.

Pharmacists bill the province every two weeks for medication dispensed to ODB patients and are paid shortly afterwards.

Dishonest pharmacists over-bill by tacking extra drugs that they never dispensed onto these bills so that they are reimbursed for more drugs than they have sold. Untold millions earmarked for the sick and needy end up in their pockets.

Read the full article at Global News

Filed Under: Health Fraud Series, Healthcare Fraud Tagged With: health care fraud, healthcare criminality, Ontario healthcare system, Ontario Minister of health, provincial government

Ontario failing to recover millions in fraudulent OHIP billings by doctors

March 11, 2019

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

 

Filed Under: Government, Health Fraud Series Tagged With: health care system, healthcare criminality, healthcare fraud and waste

Dispensing Harm. How a handful of pharmacists flooded Ontario’s streets with lethal fentanyl amid a national opioid crisis

March 11, 2019

A burly man wearing a clown mask walks into a pharmacy. Brandishing a large knife, he heads straight for the dispensing counter and hands the pharmacist a note.

The pharmacist, Waseem Shaheen, opens the narcotics safe and fills a white garbage bag with fentanyl patches while the impatient robber waves his knife threateningly.

Shaheen hands over the bag and drops to his knees, hands in the air as the clown robber thrusts the knife through the air a few more times before beating a hasty retreat.

“I got robbed,” Shaheen told a 911 operator minutes later.

“What was taken?” the operator asked.

“Everything.”

Only this was no robbery at all.

It was a charade, concocted by Shaheen to cover up an illicit drug-dealing operation in which he trafficked at least 5,000 fentanyl patches out the back door of his Ottawa pharmacy.

While the provincial government monitors the prescribing and dispensing of opioids in Ontario, no alarms were raised by the conspicuous volumes moving through Shaheen’s pharmacy.

Read more at Global News

Filed Under: Government, Healthcare Waste Tagged With: healthcare criminality, healthcare fraud, Opioids, organized criminality in healthcare

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