Ontario doctor who charged for tests he didn't do may still keep the money
Ontario's physician watchdog has come down as hard as it can on a doctor who it found billed the province's public medical system for tens of thousands of tests he didn't do — but the maximum penalty doesn't come close to the money he took.
And one way to recover much more money that was put into place three years ago has never been used, CTV News has learned — one sign critics say the government has yet to properly oversee expenses that run into the billions of dollars.
“Dr. Ayokunle Fagbemigun’s misconduct is extremely serious. He took hundreds of thousands of dollars from the health care system to which he was not entitled. He did so intentionally, and for personal gain. He defrauded the government many times over an extended period,” wrote a panel of the Ontario Physicians and Surgeons Discipline Tribunal in a decision released Thursday.
Fagbemigun, who works at a small practice in north Etobicoke, was found to have billed for 42,000 tests and procedures that didn’t happen, becoming the top biller for several procedures in a four-year span. The pattern was caught by federal auditors, who referred it to the province’s regulators for action.
MORE: Ontario doctor billed for 42,000 tests he didn't do, investigation finds
He will have his registration revoked, will face a $35,000 fine, and will pay $72,590 in costs.
But that’s a fraction of what CTV News estimates the tests and procedures cost OHIP, the provincial health-care plan: between $270,000 and $410,000.
“This tribunal has no power to order Dr. Fagbemigun to repay the monies he took. That is a matter for the courts, if OHIP decides to pursue it,” the panel wrote.
For years, there was no option for the provincial government to recover these funds. Then in 2019, Ontario’s Ministry of Health told CTV News they passed a new law that allowed the government to retrieve the money.
“Under the current legislative framework, the general manager of OHIP may refer the matter to the Health Services Appeal and Review Board (HSARB) for a hearing,” wrote a minister spokesperson.
Dr. Ayokunle Fagbemigun is seen in this undated image.
That review board operates out of a building on Bloor Street. And its registrar told us that of the cases before it so far, there have been at least 36 instances of doctors trying to recover money from OHIP, and none of OHIP trying to recover money from doctors.
“To date, all the matters before the Board have been requested by physicians to review a decision of the general manager of OHIP where the general manager has either refused to pay, paid a reduced amount, or paid for the service the general manager considers to have been provided and not the service described in the claim,” said Hassan Badreddine, the HSARB’s senior manager and registrar.
- Download our app to get local alerts to your device
- Get the latest local updates right to your inbox
It’s possible that some funds have been recovered voluntarily or through a settlement, but the Health Ministry couldn’t provide figures.
All of this is a sign that the province is not serious about discovering overpayments, or collecting overpayments when they are discovered, said Natalie Mehra of the Ontario Health Coalition.
“It’s very frustrating because this was an issue that was raised six years ago by the Auditor General,” Mehra said in an interview. “It’s frustrating to not see something done about a long standing issue.”
Attempts by CTV News to speak to political leadership have so far been rebuffed. Former Health Minister Christine Elliott did not stand for re-election, and Parliamentary Assistant to the Minister of Health Robin Martin has not returned calls.
Fagbemigun administered several tests to patients they didn’t need, including drug testing patients as young as nine years old, and offering another patient eight pregnancy tests in a year, even though she was not sexually active.
He closed the door on a reporter and photographer at his north Etobicoke practice this week. Through a secretary, he said he was not interested in talking to the press.
CTVNews.ca Top Stories
Canadian gov't proposes new foreign influence registry as part of wide-spanning new bill
Prime Minister Justin Trudeau's government is proposing a suite of new measures and law changes aimed at countering foreign interference in Canada, amid extensive scrutiny over past meddling attempts and an ever-evolving threat landscape.
Boeing Starliner capsule's first crewed test flight postponed
The long-awaited first crewed test flight of Boeing's new Starliner space capsule was called off for at least 24 hours over a technical issue that launch teams were unable to resolve in time for the planned Monday night lift-off.
Teacher charged in historical sexual assault of Calgary teenage girl
Calgary police have charged a teacher with the alleged sexual assault of a teenage girl more than 20 years ago.
Winnipeg man admits to killing four women, argues he's not criminally responsible
Defence lawyers of Jeremy Skibicki have admitted in court the accused killed four Indigenous women, but argues he is not criminally responsible for the deaths by way of mental disorder – this latest development has triggered a judge-alone trial rather than a jury trial.
Man banned from owning animals after fatal Calgary dog attack
The owner of three Calgary dogs that got loose and mauled a woman to death in 2022 has been ordered to pay a $15,000 fine within one year and banned from owning any animal for 15 years.
East-end Ottawa family dealing with massive rat infestation
Residents in Ottawa’s Elmridge Gardens complex are dealing with a rat infestation that just won’t go away. Now, after doing everything they can to try to fix the issue, they are pleading with the city to step in and help.
Mediterranean staple may lower your risk of death from dementia, study finds
A daily spoonful of olive oil could lower your risk of dying from dementia, according to a new study by Harvard scientists.
An El Nino-less summer is coming. Here's what that could mean for Canada
As Canadians brace themselves for summer temperatures, forecasters say a weakening El Nino cycle doesn’t mean relief from the heat.
Newfoundland and Labrador latest province to tighten rules on Airbnbs
Newfoundland and Labrador is the latest jurisdiction to bring in stricter rules for short-term rentals, with a coming set of regulations that will force operators to register with the provincial government.