TORONTO - There's little oversight and a lot of waste in an Ontario government program that helps pay for wheelchairs and other medical devices such as hearing aids and electric scooters, auditor general Jim McCarter said Monday.
The province's spending on assistive medical devices skyrocketed to $347 million last year, up more than 90 per cent since the last audit in 2002, and the Ministry of Health is paying huge markups for some of the items, said McCarter.
"We feel they're overpaying, and significantly overpaying," McCarter said after tabling his annual report.
"I can't give you a dollar figure, but it would certainly be in the millions of dollars that they're overpaying."
The government needs to act like any other consumer seeking big ticket items and shop around for the best price, advised McCarter.
"In our opinion, clearly they could be acquiring these devices for a lot less money than they're currently paying," he said.
"The auditor general's report highlights a continued culture of mismanagement at the Ministry of Health that extend far beyond the eHealth scandal," said Progressive Conservative Leader Tim Hudak, referencing the agency tasked with creating electronic health records that spent $1 billion with little to show for it.
The Ministry of Health paid up to 128 per cent over the vendor's costs in some cases, well above its target of a 33 per cent markup, said McCarter.
For example, he found the ministry was paying vendors $23,000 over five years for a home oxygen concentrator, when the device cost only $400 to $1,000 each to buy and last up to seven years.
Spending on powered scooters to help people with mobility problems increased a whopping 109 per cent in three years, soaring to $800 million last year.
Claims for a type of hearing aid that operates on the FM radio frequency jumped 1,800 per cent in just four years to $4.8 million.
The government has set up a special committee to develop new eligibility criteria for these devices, but the auditor said it should have acted faster.
"The ministry's actions could have been more timely, given that claims began to increase significantly more than three years ago," said McCarter.
The auditor found an "unreasonably long time lag" between the date of a home oxygen clients death and the date the government's records are updated, which means it keeps sending out payments for the oxygen for the deceased person.
The government is now looking in its records as far back as 2001 to try to get back some of the overpayments, and has already recovered about $1.2 million from vendors.
One company that sells hearing aids from multiple locations had claims totalling more than $10 million since the year 2000, and just one doctor prescribed most of those claims.
The OPP were called in twice, in 2004 and again this year, to investigate the possible conflict of interest, but the Ministry of Health says it can't cancel agreements with the vendor while the issue is under investigation by police.
A vendor of respiratory devices submitted more than 5,5000 claims amounting to $4.7 million since 2003, but only one doctor was responsible for prescribing 94 per cent of those claims.
That same vendor submitted about 2,700 claims just in 2005 for other respiratory devices, amounting to $2.3 million, and again, one doctor was responsible for prescribing 92 per cent of the claims.
"This indicates a potential financial dependence between the vendor and physician, and therefore a potential conflict of interest," wrote the auditor.
"We found that (the ministry) seldom took action to address the problem."
It isn't just the government that ends up overpaying, said McCarter.
"The people who need these devices often have to pay part of the cost themselves," he said.
"So if the government is paying too much, so are they."