Canada: Windsor doctor charged OHIP $2 million; Chatham doctor billed $4 million - PressFrom - Canada
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CanadaWindsor doctor charged OHIP $2 million; Chatham doctor billed $4 million

07:35  18 july  2019
07:35  18 july  2019 Source:   windsorstar.com

Toronto doctor surrenders licence amid investigation into improper billing, ending his 30-year medical career in Canada

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Chatham ophthalmologist Christopher Anjema has billed the Ontario Health Insurance Plan for treating patients suffering from common eye problems such as cataracts and glaucoma. He has also charged the province for doing a not-so-common eyelid reconstruction procedure — again and again.

Windsor doctor charged OHIP $2 million; Chatham doctor billed $4 million A number of OHIP cards are shown in this file photo.

Anne Jarvis and Trevor Wilhelm

A Chatham ophthalmologist who charged OHIP $4.1 million in one year — making him the highest-billing doctor in the region — says his big bills were the result of large overhead costs and increasing patient visits.

Dr. Christopher Anjema was fourth in the province and first in the Erie St. Clair LHIN on a database of Ontario’s top-billing doctors recently published by the Toronto Star.

Anjema billed the Ontario Health Insurance Plan $4.1 million in the 2017-2018 fiscal year, and $31.4 million since 2011.

“Advancements in technology and treatment protocols have led to early detection and treatment of eye disease and conditions causing vision impairment but they often require more patient encounters,” the Anjema Eye Institute said in a statement emailed to the Windsor Star. “For example, in 2017 alone, Dr. Anjema treated over 6,000 patients which resulted in more than 19,000 patient encounters.”

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Ontario in 2013, billing over million , while another two doctors charged over $ 4 million , and 28 billed over $ 2 million . The average Ontario doctor bills OHIP 0,000 a year, but must pay staff and any office Windsor doctor charged with fraud. Ontario to crack down on illegal medical billing .

Dr . Ray Callas, an anesthesiologist from Beaumont who testified Tuesday, said afterward in an emailed statement that he has not been through a mediation Without mediation, she said, that million reduction in billed charges would have most likely been borne by patients. "What it does show is

The Toronto Star published, for the first time, a database of the top 100 billings between fiscal 2011-12 and 2017-18. The paper began with a Freedom of Information request five years ago for Ministry of Health data. The Ontario Medical Association fought it all the way to the Supreme Court.

Of the 31,500 practising physicians in Ontario, 194 made it to the Top 100 billers sometime between 2011 and 2018.

A total of 19 doctors from the Erie St. Clair Local Health Integration Network, which oversees health care in Windsor and Essex, Chatham-Kent and Lambton counties, made the so-called Top 100. Fifteen are in Windsor and Essex County. One is in Chatham, and three are in Sarnia.

Anjema’s email stated OHIP payments are not the same thing as a doctor’s income. OHIP billings are used to pay for overhead such as rent and utilities, staff salaries, and leading-edge equipment that requires regular upgrades or replacement.

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Number of Units. Any One One or more Two Two or more Three Three or more Four Four or more Less than five Five Five or more Six Six or more Seven Seven or more Eight Eight or more Nine Nine or more.

At least two other doctors charged over $ 4 million -- and 28 billed over $ 2 million -- but all the public can find out is The average Ontario doctor bills OHIP 0,000 a year, but must pay staff and any office expenses out of that amount, which the group DoctorsOntario estimates at 30 per cent of billings.

“In the Ophthalmology branch of medicine, these costs can amount to as much as 50% of the gross billings,” the email stated.

Anjema said he has an office in Chatham and one in Sarnia with a combined 20,000 square feet of space. He also has 24 staff, including certified technicians, who are paid from the doctor’s gross OHIP billings.

Dr. John Speirs, an interventional radiologist in Windsor, was the highest billing doctor in the city and the 27th highest in Ontario, according to the Toronto Star report. He billed OHIP $2.16 million in 2017-2018. Speirs, who billed almost $313,000 more than the second highest-billing doctor in the city and county, was also a top biller each of the previous six years.

Cardiologist Dr. Roland Mikhail, who billed $1.85 million, was the second highest biller in Windsor and the 48th highest in the province. He billed the government almost 208 per cent more than the most recent annual average of $601,271 for cardiologists in Ontario.

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Find a Doctor in Windsor , Ontario . Family Doctors and Specialist Directory. Clinic Locations, Phone Numbers and Doctor Ratings. Page 1. Doctors in Windsor , Ontario (498 Doctors Listed).

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Ophthalmologist Dr. Donald Fiander, who billed $1.81 million, was the third highest biller here and the 50th highest in the province. Fiander, who was also a top biller four of the previous six years, billed almost 150 per cent more than the most recent annual average of $723,768 for Ontario ophthalmologists.

Doctors Speirs and Mikhail didn’t respond to requests for comment. Dr. Fiander couldn’t be reached.

The government paid doctors $12 billion in 2017-18.

Of the 15 doctors in Windsor and Essex County, six are radiologists, four are ophthalmologists and three are cardiologists. Those specialties are sometimes known as the “Big Three,” The Toronto Star noted. Radiologists provide a very high volume of service. Ophthalmologists and cardiologists provide a high volume of service, and the fees for those services are high.

All six radiologists here practise primarily or at least in part at Clear Medical Imaging on Ouellette Avenue.

Two of the 15 doctors in the Windsor area — Dr. Anwar Hasan and Dr. Curt Wimmer — are listed as practising emergency medicine. But Hasan practises primarily at InMedic Pain Management Centre on Tecumseh Road East. Wimmer is also licensed to practise pain medicine. Three of the highest billing doctors in Ontario practice pain management.

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Health minister flags 500 doctors who made more than million last year in a bid for public support in reforming outdated OHIP system. An eye specialist who charged the Ontario Health Insurance Plan a “staggering” .6 million last year is one of 500 doctors on a secret list billing more than

The most expensive doctor in Ontario , an eye specialist, billed the province for .6 million last year. They represent just two per cent of all doctors , but cost 7 million a year, or over six per cent of the And many of them charge much more than million , the government’s release shows.

Windsor doctor charged OHIP $2 million; Chatham doctor billed $4 million© Dan Janisse The exterior of InMedic Pain Management Centres at 13158 Tecumseh Rd E in Tecumseh is shown on Friday, July 12, 2019.

“Treatment of chronic pain patients is often complicated and involves multiple services, interpretations, and procedures,” Hasan said in a written response to The Windsor Star. “We are committed to ensuring we address all the needs of our patients on each visit. This includes, for some patients, multiple procedures in a single visit.”

His practice allows patients to return to their jobs and other activities sooner and enjoy a better life, he wrote.

Doctors are paid several different ways, but most receive some of their pay through fees for services, billing OHIP for each consultation, test and procedure they perform. The fees are negotiated by the OMA and the government.

“The amount a physician bills for a service is not their salary or take-home pay,” Hasan wrote.

They often have significant expenses such as office rent, staff salaries, equipment and supplies, all paid with revenue from their billings.

“Unlike other groups and employees who have their salaries disclosed as part of the Sunshine List in Ontario, physicians do not receive pension, maternity or paternity leave, vacation time or benefits as part of their billings,” wrote Hasan.

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We provide expertise in OHIP billing codes, EMR and workflow and roster management. 1,200+ doctors count on us. Over 1,200 doctors have improved the lives of more than 1.5 million patients with DoctorCare’s help. I heard about them from a few other colleagues in another Windsor FHO.

Asked by the Toronto Star what he thinks of doctors’ billings being public, Hasan wrote that the public’s right to know how health care funding is spent “must be balanced with the right to privacy for individual physicians…”

Four of the 15 local doctors on the list — Wimmer, radiologist Dr. Julie Hausmann, nephrologist Dr. Albert Kadri and radiologist Dr. Brigitte Ala — are flagged on the College of Physicians and Surgeons website. Wimmer’s and Hausmann’s practices are limited to their specialties, possibly because they both trained in a foreign country, the United States, and are relatively new here. There is no indication of concern.

Windsor doctor charged OHIP $2 million; Chatham doctor billed $4 million© Dan Janisse The exterior of InMedic Pain Management Centres at 13158 Tecumseh Rd E in Tecumseh is shown on Friday, July 12, 2019.

Kadri is flagged for having his privileges at Windsor Regional Hospital suspended last year. He still practises at his Windsor Regional Kidney Care Centre on Ouellette Avenue and is appealing his suspension to an external tribunal called the Health Professions Appeal and Review Board. The hearing is expected this year.

In a very public feud over patient care policy, the hospital has called Kadri’s behaviour “inappropriate” and “disruptive.” The hospital also alleged Kadri billed OHIP for patient treatment even when he was not the nephrologist on call, which he refuted.

Kadri has charged that he was unfairly targeted because he would not fall in line with changes to billing and patient care policies. He is also suing the hospital over unrelated alleged plagiarism.

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Most private insurance companies follow suit. So, I can bill 000 dollars…it wouldn’t matter. Just think about a hypoyhetical average neurosurgeon in ny who is pulling in 2 million dollars from his hospital now his bonus from Thus this doctor ’s total income is about 4 million dollars.

For example, you write one million as 1,000,000 rather than 1000000. As another example, it's much easier to remember that a trillion is written with four sets of three zeros than it is to count out 12 The number is larger than the number of atoms in the universe. Million and Billion: American vs. British.

Kadri, the only nephrologist in Ontario in the Top 100, billed OHIP for $1.52 million in 2016-2017, making him the 98th highest billing doctor in Ontario.

He did not respond to a request for comment.

Ala is flagged because Windsor Regional Hospital put conditions on her privileges in 2017-18 and required her to get coaching in “professionalism.” The college also summoned her to its office in 2018 to be cautioned over conflict of interest. She also did not respond to a request for comment.

Following a complaint by the hospital and an investigation by the college, Ala acknowledged that she had transferred “certain” patients referred to the hospital over to Windsor Radiological Associates instead, where she had a financial interest.

The college concluded in its complaint summary that it was “troubling” that even after coaching on professionalism, “she defended her behaviour and attempted to justify it by citing the long wait times at the hospital. It was not apparent to the committee that Dr. Ala had developed any insight into her conduct in this matter…”

Ala billed OHIP $1.69 million in 2017-18, making her the 79th highest billing doctor in Ontario. She was also among the top billers in 2016-17.

The college is also investigating Anjema’s “standard of practice.” In the meantime, he can perform blepharoplasty — plastic surgery on eyelids — only under the guidance of a clinical supervisor acceptable to the college.

Related

The college also cautioned him on his clinical care and professionalism in 2017 and ordered him to complete a continuing education and remediation program. It ruled he had failed to properly address an emergency department patient with an eye infection after cataract surgery.

Anjema should have been “far more comprehensive and careful in his review and consideration of the patient’s history and presentation,” the college ruled.

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His clinic said Anjema welcomes regular reviews: “Audits are a standard part of medical practice in Ontario and the Anjema Eye Institute is pleased to participate in these and to cooperate fully to ensure compliance as we strive to provide the highest standard of care. We are proud of the work we do and of the lives we’ve helped change for the better.”

[email protected]

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Top local billers

The 19 doctors in the Erie St. Clair LHIN who made the Top 100, by name, specialty, city, billings, rank and year:

Christopher Anjema (ophthalmology), Chatham — $4.1 million, 4th, 2017-18

John Speirs (diagnostic radiology), Windsor — $2.16 million, 27th, 2017-18

Rishi Duggal (diagnostic radiology), Sarnia — $2.07 million, 34th, 2017-18

Murari Patodia (ophthalmology), Sarnia — $1.93 million, 42nd, 2017-18

Roland Mikhail (cardiology), Windsor — $1.85 million, 48th, 2017-18

Donald Fiander (ophthalmology), Windsor — $1.8 million, 50th, 2017-18

Robin Deans, (ophthalmology), Windsor — $1.8 million, 52nd, 2017-18

Curt Wimmer (emergency medicine), Windsor — $1.78 million, 57th, 2016-17

Anwar Hasan (emergency medicine), Tecumseh — $1.77 million, 63rd, 2017-18

Igor Gaisinsky (diagnostic radiology), Windsor — $1.77 million, 65th, 2017-18

Kirenza Francis (diagnostic radiology), Windsor — $1.76 million, 67th, 2017-18

David Adekoya (emergency medicine), Windsor — $1.75 million, 69th, 2017-18

Julie Hausmann (diagnostic radiology), Windsor — $1.74 million, 70th, 2017-18

Patrick Cervini (diagnostic radiology), Windsor — $1.7 million, 76th, 2017-18

Brigitte Ala (diagnostic radiology), Windsor — $1.69 million, 79th, 2017-18

Fahim Ibrahim (ophthalmology), Point Edward — $1.65 million, 87th, 2017-18

Fouad Tayfour (ophthalmology), Windsor — $1.59 million, 96th, 2017-18

Amr Morsi (cardiology), Windsor — $1.43 million, 97th, 2012-13

Albert Kadri (nephrology), Windsor — $1.52 million, 98th, 2016-17

Wadea Tarhuni (cardiology), Windsor — $1.51 million, 100th, 2015-16

Are doctors billing too often for ‘low value’ procedures? Some experts think so.
It’s a test fictional doctors on medical dramas like Grey’s Anatomy often dramatically order at the beginning of an episode: the ECG or EKG, short for electrocardiogram. It saves lives — both onscreen and off. But when done unnecessarily it can cause patients harm, and waste money in a public system where there never seems to be enough to go around. And it’s not the only test or procedure that experts sometimes question. A committee of the Ontario Medical Association (OMA), which represents the political and economic interests of 31,500 doctors in the province, and the Ministry of Health has been tasked with finding $460 million in savings by 2021 through eliminating or rest

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