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Be on guard for for-profit healthcare scams

John Bell

July 14, 2023
Reports abound of medical clinics and testing companies billing patients for tests and procedures prescribed by doctors – thing that are supposed to be covered by OHIP.
Companies like LifeLabs were caught red-handed billing doctor-ordered blood tests. When caught the corporation said they had made a mistake and the Ontario Health Ministry reiteratedthat doctor-ordered tests are indeed paid by OHIP – at least so far. There are no guarantees that the Ford government won’t try to slap fees on such tests in the future. 
Many patients simply paid. Patients are often bewildered by changes going on in our system. They are in a vulnerable position. Many have language issues. The system is stacked against them, to make standing up for their rights difficult.
Now, Toronto’s largest hospital has pulled a similar scam. The University Health Network (comprised of Toronto General, Toronto Western, and Princess Margaret Hospitals) sent an email form to at least 100 patients billing them $120for prescribed Vestibular Head Impulse Tests, for people with acute vertigo. What is more, the extra billing was announced as a precondition for the test. There is no way to know how many patients declined the test because they couldn’t afford it. 
At least 20 of the patients who received the e-bill payed the $120 and will have to be reimbursed.
Akio Maroon is the patient who stood up and blew the whistle on UHN, through social media. Regular news outlets picked up the story. “If I hadn't tweeted about this three days ago, where would we be?” Maroon said.
The hospital quickly backtracked, writing: “The error originated as a result of a communication and interpretation error with the physicians practice and billings department around covered and uncovered services.”
So we are left with 2 possible interpretations: either a major Canadian Hospital is incompetent and no longer clear about what is and is not covered by OHIP; or they are trying to grab new revenue hoping that patients don’t notice or are not confident to question the bill.
Attempts to fob this off as an isolated clerical error, the mistake of one uninformed worker don’t make sense. Anyone that has worked in a big institution knows that a formal billing, like this questionable e-bill, is written, edited and vetted by multiple layers of bureaucracy. The “failure to communicate” excuse rings hollow.
It is on patients to scrutinize any extra bills for medical procedures. We can expect more such “mistakes” in future. If you have doubts or questions about mysterious bills for tests or procedure, contact OHIPor report it to the Ontario Health Coalition. And prepare for a major, province-wide mobilization against healthcare privatization tentatively scheduled for late September.
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