A Kingston, Ont., doctor┬аcelebrated for organizing┬аdrive-thru vaccination clinics that helped thousands get shots at the height of the COVID-19 pandemic┬аis now being ordered to pay back more than $600,000 in fees for those same services.
Dr. Elaine Ma said she organized 45┬аmass vaccination clinics that administered roughly┬а35,000┬аdoses between April 2021 and the following February.
Her┬аwork was recognized by the Ontario College of Family Physicians, which granted her its Award of Excellence in 2021, in part pointing to Ma’s┬аrole in boosting local vaccination rates.
About a year later, the doctor┬аsaid she┬аreceived notice from the┬аOntario Health Insurance Plan (OHIP) seeking to recoup the money she had billed for the shots┬атАФ approximately $600,000, plus around $35,000 in interest.
“I was shocked that OHIP chose to do this and chose to not look at the big picture here, which is, we saved lives,” said Ma, adding that although only a few years have passed, people already seem to be forgetting what life was like amid the first waves of COVID-19.
Answering the ‘call to arms’
At the time,┬аPremier Doug Ford and retired general Rick Hillier, who was overseeing Ontario’s vaccine rollout,┬аwere urging people to get their shots, Ma recalled.
“We answered the call to arms. We did it on good faith. We did it because people would end up in ICUs┬атАФ┬аor worse, dead┬атАФ if they weren’t vaccinated,” said Ma, whose story was first reported by local news outlet Kingstonist.
It’s a situation the president of the Ontario Medical Association said┬аrewards a “heroic effort” with┬аrigid bureaucracy. Kingston’s┬аmedical officer of health believes it could┬аhave a┬а“catastrophic” chilling effect on┬аingenuity the next time the province asks physicians for help responding to an emergency.
No one is disputing that Ma set up the clinics and doled out tens of thousands of doses, but the doctor said OHIP is arguing she was not allowed to delegate tasks┬аoutside the four walls of her office┬аwithout written approval,┬аbased on┬аa bulletin issued 20 years earlier.
A copy of the document, obtained by Radio-Canada, also states that as of April 2001, the┬аperson carrying out a procedure must be an employee.
That┬аmeans the use of medical students from Queen’s University to provide inoculations┬аwas┬аa┬а“misuse of the billing code” Ma relied on, according to a spokesperson for Ontario Health Minister Sylvia Jones.
Ministry investigating claim doctor ‘pocketed’ funds
In a statement to CBC, Hannah Jensen wrote that during┬аthe COVID-19 pandemic, a ministerial order was issued┬аoffering an hourly rate for all insured services at assessment centres, including vaccinations.
Doctors could also bill existing fees for vaccines given in their offices if they or their staff administered┬аthe shots, but if that order wasn’t followed correctly, physicians would need to return the fees they┬а“improperly” collected, she stated.
“No other doctor in the province who ran a mass vaccination clinic is having this issue,” Jensen wrote in an email, when asked about the situation faced┬аby Ma.
“This doctor billed the Ministry for over 23,000 vaccines over 5 days, incorrectly billing the Ministry for $630,000, 21 times their eligible payments.”
Jensen said the ministry is also investigating a claim┬аthat Ma paid┬аvolunteers┬а“20% of the total claim and pocketed the remaining amount.” However, the ministry would not provide┬аfurther details about the allegation.
Ma said she used the same billing code she’d used in the past for vaccinations such as the flu shot. And while OHIP seems focused on the five or six busiest clinics she led, the amount she’s being asked to repay accumulated during dozens of others, according to the doctor.
She also said OHIP is ignoring┬аthe┬аdays of work before and after each clinic, including training medical students,┬аdrawing up thousands of vaccines and making sure they were tracked in a provincial database.
“They’re┬аsaying, ‘Ooh, one doctor shouldn’t make money, or not to that extent,'” said Ma, who pointed out similar mass-vaccination clinics carried out by pharmacies or public health units have escaped similar claims.
While the money she’s being asked to repay is a worry, Ma said she’s more concerned about the principle┬аof punishing a doctor who did her part to help during a crisis, and the limits that┬аcould be placed on training for medical students.
“Doctors are now afraid of being targeted by OHIP for doing what is the right thing, which is helping our patients,” she explained.
Ma described the tone of the ministry’s statement as “accusatory,” adding the only investigation she’s aware of is the OHIP dispute, which┬аresulted in her spending the past two weeks at a hearing before the Health Services Appeal and Review Board in Toronto.
“It’s very disheartening and discouraging to hear that that’s what the Ministry of Health thinks of me,” she┬аsaid.
Doctor’s efforts were ‘heroic’
It also stands in stark contrast to┬аthe praise from Ma’s┬аmedical colleagues.
Dr. Dominik Nowak, president of the Ontario Medical Association, called Ma’s efforts during the pandemic “heroic.”
“This is an example of a doctor that should be celebrated, rather than having barriers and clawbacks┬аand┬аa bureaucracy that’s unnecessarily rigid,” he said.┬а
Nowak described OHIP’s apparent “hunt” for a reason to recover money from a physician┬аwho tried to lend a hand during the pandemic as a “breach of trust.”
Dr. Piotr Oglaza, medical officer of health for Kingston, Frontenac and Lennox┬а&┬аAddington┬аPublic Health,┬аsaid Ma’s clinics had the full support of his organization. He even participated as a volunteer.
He wrote a┬аletter to the board on her behalf urging┬аit to consider the context in which her clinics were held, and crediting the drive-thru model with relieving pressure on the public health system by providing┬аroughly seven per cent of all doses administered in the region.
Oglaza said neither he nor Ma were aware of the OHIP bulletin she’s┬аnow accused on contravening. Had he been, he said he would have raised it with the province┬аand has┬аno doubt it would have been┬аwaived, given the desperate push for vaccinations at the time.
He also warned Ma’s ordeal┬аcould discourage┬аphysicians from taking┬аon the logistics and liability of a mass vaccination┬аproject the next time Ontario faces an emergency,┬аbecause they risk getting caught up in technicalities from OHIP.
“I think that that will be really, truly catastrophic,” said Oglaza.
