Six pharmacists claimed Quebec for up to $ 650,000, including billing for services they said they gave to patients who had died.
The new data released yesterday by the Régie de l’assurance maladie du Québec (RAMQ) is surprising. Of the 15 pharmacists who were overcharged in the last year, six of them did so with deceased or hospitalized patients.
Pharmacists are entitled to fees each time they perform a prescription or perform certain other acts related to medications.
Some have thus taken the audacity to bill the Régie for patients who had given up the ghost, in order to increase their income.
The RAMQ data do not allow to know whether these are bona fide errors or fraudulent maneuvers.
In the case of hospitalized patients, it is the institution that takes care of the medication. A pharmacist can not claim services for a client who is on a hospital bed.
$ 2.7 million overpayment
In total, Quebec has claimed a little over $ 2.7 million from the pharmacists at fault.
In addition to amounts invoiced for dead or hospitalized, we learn that pharmacists charged sums for drugs that were never delivered to customers.
This is the case of a pharmacist who claimed services not rendered for 57 different drugs. In total, the RAMQ claimed $ 649,414.
This is the first time since 2016 that the RAMQ has made public complaints about pharmacists.
Prior to this date, overpayments were not recovered unless a patient requested it. The Health Insurance Act was amended to give more powers to the Régie’s investigators.
Other survey results, concerning doctors, had been made public in December. No less than 112 doctors had claimed more than $ 6 million overcharged since 2013.
A psychiatrist alone had overcharged for just over $ 1 million.
Names remain hidden
It is impossible to know who the offending health professionals are. The Régie decided not to reveal the identity of those who overcharged.
She had to make some of these names public yesterday, including those doctors fined as a result of investigations, but she retreated.
The federations of medical specialists and general practitioners oppose this publication. Legal proceedings were initiated to challenge the article of the law that was to make them public.
Health Minister Danielle McCann, however, promised that the names would be made public two months ago.
“We are the government of transparency. It’s over the culture of secrecy as it was lived with the Liberal government, “said the minister.
She reacted to the RAMQ’s decision not to provide a copy of 24 investigation files promised to our Investigation Office for a year.
FOUR TROUBLING CASES
He charges all the wind
A pharmacist had to repay not less than $ 650,000 to the Régie. He is accused of having billed for dead patients, but also of claiming services for 57 different drugs.
The Régie has claimed nearly $ 115,000 from a pharmacist. RAMQ investigators found that he had sold more expensive drugs than the price he had paid for them. Pharmacists do not have the right to make a profit on the price of a medicine.
Insulin in syringe
The pharmacist investigation determined that he was not complying with the compensation agreement by using insulin syringes.
Two pharmacists were caught charging their services for hospitalized patients. However, when someone is in the hospital, it is the pharmacist of the institution, paid at salary, who takes charge.