Login

Doctor who deceptively bills OHIP may have registration certificate revoked: discipline committee

Doctor’s misconduct has damaged public confidence in profession, discipline committee says

Doctor who deceptively bills OHIP may have registration certificate revoked: discipline committee

A medical professional who deliberately and dishonestly submits improper billings may face the penalty of revocation of certificate of registration.

In Ontario (College of Physicians and Surgeons of Ontario) v. Attallah, 2020 ONCPSD 38, a doctor was accused of collecting health card information from the family members of his patients. He would then, as alleged, improperly bill Ontario Health Insurance Plan using this information, as well as improperly bill OHIP for interviews with relatives and for services which he did not furnish. He was also accused of making false or inaccurate records such as medical charts to support these billings.

The Discipline Committee of the College of Physicians and Surgeons of Ontario found that the doctor had committed professional misconduct and disgraceful and dishonorable conduct. The committee imposed the penalties of revocation of the doctor’s certificate of registration, a reprimand and payment of costs of $124,440.

“No physician has the right to take improper advantage of the trust-based, fee-for-service system of compensation of physician services by submitting claims to OHIP for payment to which they know they are not entitled,” the committee wrote.

The committee found that the doctor’s acts constituted deliberate and dishonest conduct, for which the primary penalty considerations are the protection of the public and the maintenance of public confidence in the profession.

The committee cited Ontario (College of Physicians and Surgeons of Ontario) v. Taylor, 2016 ONCPSD 22, which also involved a case of deceptive billing, which calls for the committee to consider general deterrence when deciding upon the proper penalties. In such a situation, the penalty imposed is meant to demonstrate to the profession that such dishonest and deceitful behaviour will not be tolerated.

The doctor’s misconduct was very serious, intentional and ongoing, the committee found. Patients, family members and the Ministry of Health all raised their concerns with him, but he continued committing the alleged acts. The doctor’s actions not only breached the trust of his patients, his colleagues and the broader society but also created potential problems for his patients’ future medical care and health insurance matters, the committee said.

The committee considered the nature of the misconduct, which it found to be deliberate and ongoing, and the doctor’s involvement of his office staff to be aggravating factors. The committee also listed several possible mitigating factors, such as character references, payment, quantum of improper billings, and the absence of previous discipline matters, but accorded these factors limited significance. The committee opined that the doctor neither showed an understanding of what he had done wrong nor offered a meaningful plan for change.

Related stories

Free newsletter

The Canadian Legal Newswire is a FREE newsletter that keeps you up to date on news and analysis about the Canadian legal scene. A separate InHouse Edition is delivered on a regular basis, providing targeted news and information of interest to in-house counsel.

Please enter your email address below to subscribe.

Recent articles & video

Virtual arbitral hearings: Arbitrations are proceeding remotely with ‘enormous financial savings’

Canada’s top Wills, Trusts, & Estates boutiques for 2021 revealed

Changes to IP laws offers an easier path to industrial design protection, says Oyen Wiggs lawyer

University of Manitoba business law clinic aims to help entrepreneurs, innovators strapped for cash

Expediting the COVID response: how intellectual property regulators and tribunals have stepped up

More work needed to end violence against Indigenous women, LEAF says about Gladue retrial

Most Read Articles

Calgary lawyer Jeff Kahane could have bought carbon credits, but instead purchased land in B.C.

Manitoban on disability assistance wins right to appeal being forced to go on Old Age Pension at 65

Canadian Judicial Council to take no further action on matter of Quebec Superior Court chief justice

McLeish Orlando’s Lindsay Charles reflects on her journey to becoming a partner at the firm