Pharmacies caught milking the system
Sep 30, 2012 / 7:35 am
The federal government has set its sights on a pair of pharmacies in Nova Scotia and Saskatchewan over allegations they submitted phoney claims to the aboriginal health-benefits plan, The Canadian Press has learned.
A government report and documents filed in a Nova Scotia court contain information on two more cases in which the Non-Insured Health Benefits program has purportedly fallen prey to wrongdoing.
Health Canada has also called in the Mounties in one case.
The NIHB program provides coverage to eligible First Nations people and Inuit when they are not insured by private or provincial plans.
A months-long investigation by The Canadian Press has uncovered a string of alleged abuses of federal money for aboriginal health care by pharmacies, a health clinic and a remote nursing station, all of which have purportedly cost taxpayers millions of dollars.
Now two more pharmacies find themselves under the microscope.
A Nova Scotia pharmacist and his numbered company face a $1.36-million lawsuit from the federal government over allegedly "fraudulent" claims. And a newly released report says Ottawa had been trying to recover $729,071 from another pharmacy in a Saskatchewan hospital that allegedly overcharged the NIHB program and billed for drugs that were not dispensed. The government is now after about half that amount.
Health Canada launched an investigation into the pharmacy at St. Joseph's Hospital in the northern Saskatchewan village of Ile-a-la-Crosse after the province's College of Pharmacists raised concerns five years ago.
Ray Joubert, registrar of the Saskatchewan College of Pharmacists, refused to release a copy of the 2007 letter to Health Canada or answer any questions about the organization's concerns about the St. Joseph's Hospital community pharmacy.
In its May 2011 report, however, Health Canada's audit team laid out a number of troubling claims of wrongdoing over a 22-month period.
"The pharmacist filled, dispensed and billed for prescriptions without authorization, billed the (NIHB) program for drugs that were not dispensed, and overcharged the program by claiming for drugs above cost and submitting more than one bill for the same drug," the report says.
The Canadian Press obtained the 32-page document, which examined the period between March 2005 and January 2007, under the Access to Information Act.
Health Canada further alleges the pharmacy's former owners, the Keewatin Yatthe Regional Health Authority, blocked the auditors' attempts to review financial records.
"(Blank) clerk attempted to locate the accounting files of the pharmacy in her computer, and realized that all of them had vanished," the report says.
"She searched for her backup files copied on a separate diskette, but they were also deleted."
The loss of the computer files apparently baffled the clerk.
"According to the employee, these files were available shortly before the start of the examination, and their disappearance coincided with the recent visit of a (Keewatin Yatthe Regional Health Authority) 'technician' who had come unexpectedly to inspect her computer," the report says.
"The auditors asked to examine the previous year's accounting records of the pharmacy located in the basement of the hospital. The records were generally available... with one notable exception: those related to the period under review were all missing."
The auditors also suspect the pharmacy sold expired medicine.
"The auditors noticed a significant volume of additional outdated products that originated from the St. Joseph pharmacy, lying on a shelf, waiting for destruction," the report says.
"Given the fact that the pharmacy was reusing drugs returned by the nursing stations, it is unknown how many times these products were charged to the NIHB. There is also a risk that some of the drugs delivered to patients were expired."
The Keewatin Yatthe Regional Health Authority, which sold the pharmacy in early 2007, said "numerous personnel changes" since the period of the audit have resulted in a "loss of corporate history and knowledge of past events and practices."
Spokesman Dale West said pharmacy operations have since changed, and the health region no longer operates on a "fee-for-service basis."
"Please be advised that the region is in receipt of a statement of claim for $355,520 and is working co-operatively with Health Canada to better understand the nature of this claim in order to reach a mutually agreeable solution," West said in an email.
"Once evidence supporting this claim is made available to and examined by the region, we will be in a better position to act and comment on this matter."
Health Canada spokeswoman Christelle Legault said the department has removed the pharmacist who worked with St. Joseph's Hospital community pharmacy from its NIHB provider list.
Read more Canada News
- Feds buying ads that don't exist
- Petition to rename Victoria Day
- Military supplies stuck in Afghanistan
- Public raising funds to buy alleged video
- Antipsychotic drug recalled in Canada
- Search resumes for missing fishermen
- PM's chief of staff resigns
- Astronaut adjusting to 'earthling' life
- Elijah Harper's body will lie in state
- Spectator killed during Jeep demo
- Panda exhibit opens at Toronto Zoo
- Fishermen missing off NB coast