Winnipeg Free Press - PRINT EDITION

College raps another MD over billing

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A doctor now working in Toronto is the latest physician to be disciplined by the College of Physicians and Surgeons of Manitoba for fraudulent billings.

Dr. Creighton Hui has repaid Manitoba Health more than $200,000 for house calls performed by a nurse practitioner in 2011 and 2012. The CPSM fined him $10,000 -- the maximum it is allowed to assess by law -- and ordered him to pay the costs of the disciplinary hearing, $28,160.25.

Doctors disciplined

The following one-time Four Rivers Medical Clinic doctors* have been disciplined by the College of Physicians and Surgeons for improper billing:

  • Dr. Stephen John Coyle: Disciplined in 2013 after inappropriately billing Manitoba Health in 2009 and 2010 for more than $285,000 for work done by a nurse practitioner and a clinical assistant. It was one of 14 disciplinary charges Coyle faced at the time.
  • Dr. Richard Letkeman: Censured in February for billing Manitoba Health nearly $40,000 for house calls between November 2010 and April 2011 he didn't make. Patients were seen by a nurse practitioner under his supervision.
  • Dr. Randy Raymond Allan: Censured in April by the college after billing the province close to $125,000 for patient house calls and office visits performed by a nurse practitioner in 2009. Allan had been previously disciplined by the college for trading prescription drugs for sex.
  • Dr. Creighton Hui: Disciplined this month for billing Manitoba Health for more than $201,223 for house calls performed by a nurse practitioner in 2011 and 2012.

*A fifth Four Rivers doctor faces a CPSM hearing this summer for similar reasons.

When Hui made the improper billings, he was employed by Four Rivers Medical Clinic, which operates locations on Broadway and Main Street.

He is the fourth physician who once worked at the clinic, owned by Internet-pharmacy pioneer Daren Jorgenson, to be disciplined by the CPSM because of questionable billings. All of them claimed fees for patient house calls or office visits performed by a nurse practitioner. The doctors then split the fees with the NP.

A fifth physician once employed at Four Rivers is expected to appear before a CPSM disciplinary panel this summer.

In a report posted on its website, the CPSM said the public reprimand is intended to protect the public.

"While there was no evidence that patients were medically harmed by Dr. Hui's actions, there was a significant inappropriate financial burden placed on the publicly funded health-care system," it said. "It is important that the public be informed that the college considers this to be wholly unacceptable."

Jorgenson said his clinic provided physicians with video equipment allowing doctors to keep in touch with the nurse practitioner on house calls. He said the use of the equipment varied from doctor to doctor.

Jorgenson also said his clinic was upfront with Manitoba Health in its use of nurse practitioners as it pressed for money-saving health reforms. He said he continually challenged Manitoba Health to send him a cease-and-desist letter but it never did.

"It's not like we were doing this in the shadows. We were trying to force change," Jorgenson said Friday.

"That's not fraud. Why did Manitoba Health keep paying us the whole time?" he said of the practice that occurred over several years.

He accused the CPSM of targeting his clinic simply to protect doctors' turf.

At first, Hui told the CPSM he and the nurse practitioner established a live link for each patient visit, allowing him to participate in treatment decisions at a distance. He later recanted that statement, admitting he could not estimate how often the camera link was used.

Even if Hui had participated in all visits via real-time video, he would still have breached his duties to keep proper patient records, the CPSM said in its ruling.

The CPSM determined Hui paid 70 per cent of the house-call fees he collected from the province to the nurse practitioner while pocketing the rest. Four Rivers received 20 per cent of the patient-assessment fees charged, with the remaining 80 per cent split 70-30 between Hui and the NP. Again, the nurse practitioner received the bigger share.

Neither the clinic nor the nurse practitioner was named in the CPSM report.

Even though Hui kept a relatively small share of the house-call billings, he made restitution to Manitoba Health for the entire amount, the CPSM noted. Hui now practises emergency medicine in Toronto. The CPSM has forwarded its disciplinary report to its counterpart in Ontario, which may launch its own investigation. If Hui were still practising in Manitoba, he would have also faced a temporary suspension of his licence.

Republished from the Winnipeg Free Press print edition May 31, 2014 A7

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