Kingston, Ont. doctor fighting OHIP clawback of $660K in pandemic vaccination payments

A Kingston doctor is in a dispute with the Ontario Ministry of Health, which is trying to clawback more than $600,000 in OHIP payments.

The ministry suggests the doctor improperly billed for thousands of COVID-19 vaccinations during the height of the pandemic.

But Dr. Elaine Ma tells CTV News Ottawa, she did nothing wrong, and is concerned about the effect the decision could have on doctors like her moving forward.

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During the pandemic, Dr. Elaine Ma organized physician led drive through vaccination clinics in Kingston, which delivered thousands of vaccines.

"I used medical students, I used other physicians, and I used medical assistants," she said. "However, because of the context of when we were doing these, OHIP saying that doesn't count."

One of the reasons why the health ministry takes issue is that Dr. Ma used medical students to help with vaccinations.

The other, OHIP says, is because the work was done in parking lots.

In a letter to Dr. Ma from 2023 it states: "OHIP interprets 'physician's office' to mean an office that is owned or leased by the physician. As such, arrangements to use these parking lots would not meet the definition of 'physician's office.' Dr. Ma, therefore, did not demonstrate that vaccines were rendered in her office."

OHIP is demanding Dr. Ma pay back more than $600,000 dollars.

"I'm still in a bit of a state of shock that this has gone as far as it has," she told CTV News Ottawa Wednesday. "We were asked to do this. We were asked to do this quickly."

In a statement to CTV News Ottawa, Hannah Jensen, a spokesperson for the minister of health, Sylvia Jones, says "no other doctor in the province who ran a mass vaccination clinic is having this issue.

"This doctor billed the ministry for over 23,000 vaccines over five days, incorrectly billing the ministry for $630,000, 21 times their eligible payments and used Queen’s medical students as volunteers to administer vaccinations, a misuse of the billing code."

She goes on to point out "the ministry is further investigating a claim that the doctor paid the volunteers 20 per cent of the total claim and pocketed the remaining amount."

Dr. Ma is getting support in her dispute with OHIP from Dr. Piotr Oglaza, the medical officer of health for the Kingston, Frontenac, Lennox and Addington health unit.

"By providing these vaccines in that critical time before we had wide spread of Omicron, I'm sure from my professional opinion, (the clinics) prevented thousands of hospitalizations, prevented deaths, and was really critical for the well-being of this community," he said.

Dr. Elaine Ma administrate vaccine during a drive through COVID-19 vaccine clinic at St. Lawrence College in Kingston, Ontario, on Sunday January 2, 2022. (Lars Hagberg/THE CANADIAN PRESS)

Dr. Ma has spent two years fighting OHIP's claim. She says the vaccinations did not take place over a matter of days, but were done over months of clinics. She says she administered many doses herself.

She has attended hearings with regulating authorities, and insists all OHIP billing rules were followed.

She says it's standard practice to bill for work medical students are involved in, and the students were given training. She says it's not about the money for her.

"There's a bigger issue here, which is if we can't train medical students because we can't have them do procedures -- because if they do procedures, then the physician who is already not being paid is now actually giving up income to train medical students. Who's going to be willing to train our future physicians?" She added.

Her colleagues are concerned the dispute could have a chilling effect.

"This could impact future planning for future pandemics, for future emergencies," said Dr. Oglaza. "It could also impact the willingness of primary health care providers and doctors to take on risk on themselves when called upon to action during a public health emergency."

The ministry is calling for its money to be paid back in full, plus interest. For now, the dispute remains unresolved, but Dr. Ma hopes it will be soon.