Eye doctors in N.L. accused of illegally charging patients for cataract surgery: health minister
Callers to a provincial cataract surgery hotline say physicians are breaking the law by charging patients directly for a surgery that should be paid for by public health insurance — the Medical Care Plan.
Last week Health Minister John Haggie urged patients to call a 1-800 number if they had been asked to pay out-of-pocket for cataract surgery or had the surgery done outside a hospital.
The response has been overwhelming.
Haggie said, as of Tuesday, the health department has received 400 calls to its cataract surgery hotline.
‘A clear contravention of both the Canada Health Act and our own Hospital Insurance Act.’ – John Haggie
A health official has only been able to call back 90 of the callers so far, but already they’ve found 25 people who say they’ve paid a doctor up to $4000 per eye for cataract surgery.
They have also heard that patients have been told that they are going to have to wait so long to get the MCP-covered cataract surgery that the only way to get treatment quickly is to pay for it themselves.
“If they have paid for what is an insured service, that’s a clear contravention of both the Canada Health Act and our own provincial legislation, our own Hospital Insurance Act,” said Haggie.
He said if the allegations are proven, they could have serious consequences for any accused physician.
“For anyone who has been found to have done that, there is a $20,000 fine per instance. So, in this case we have 25 instances.”
Federal health transfer payment loss
These infractions could also hurt the province’s finances.
‘That’s $100,000 dollars we are losing.’ – John Haggie
Haggie says the money illegally taken from patients could be subtracted from next year’s federal health transfer payment to Newfoundland and Labrador.
“We are duty bound under the Canada Health Act to report this extra-billed money to the federal government. So next year we will lose that money off our Canada Health Transfer. So that impacts everybody, not simply the people who have been in an unfortunate situation of paying for a service they didn’t need to pay for,” said Haggie.
“If each of the 25 people we’ve heard from paid $4000, that’s $100,000 dollars we are losing for sure.”
Physicians not named
Haggie said the health department is not ready to identify any physicians who’ve been accused, or say where the infractions are alleged to have happened.
“We’re working through that with our hotline. It’s not appropriate for me to name names because as you tell from my tone and the comments I’ve made there are potential criminal activities here,” he said.
Hundreds of calls not returned yet
Haggie said a health department staff member is working to contact all the people who have called the hotline. He said more staff may be necessary if the calls continue to come in.
“We’re working our way through the other 300 calls we haven’t returned and we’ll wait and see what there is in the way of new calls. Quite frankly, if the call volume continues to rise, we may have to put other individuals on this to tidy this up in a reasonable period of time.”