An Ontario doctor who organized drive-through vaccination services during the COVID-19 pandemic has been ordered to repay over $600,000 to the Ontario Health Insurance Plan.
Doctor Elaine Ma organized medical students to vaccinate thousands of patients in their cars at the Queen’s University Richardson Stadium parking lot in Kingston, between July 2021 and January 2022. To perform these vaccination services, Ma claimed $606,657.60 from Ontario Health Insurance Plan (OHIP). She will have to pay the lion’s share back, according to a ruling by the Health Services Appeal and Review Board delivered on Nov. 26.
After granting Ma the funds, the health ministry found her claim ineligible in an audit, citing several violations related to her staff, choice of location, and record-keeping. Ma responded that the charges were based on “strict and unreasonable” interpretations of terms, court documents state, and that she acted in “good faith” during a health emergency.
The ministry’s position was that she delegated vaccination responsibilities improperly. Ma enlisted Queen’s University medical students to help administer the shots. As unpaid volunteers, the students didn’t match certain criteria for a claim, the ministry argued, as delegates must be paid “employees” of the applicant.
Another dispute centered around the term “physical office,” under which Ma’s use of a drive-through facility didn’t fall, the ministry argued.
As records go, Ma was also supposed to demonstrate which claims were for services rendered by her personally and which were administered by someone else, as each falls under different fee codes. The ministry argued that she failed to provide this documentation.
When physicians submit claims to OHIP, they are paid on the “honour system,” but the claims are subject to post-payment audits, which is what happened with Ma’s claim.
Facing these citations, Ma responded that OHIP’s interpretations of the terms “employee” and “physical office” were “strict and unreasonable,” and that the agency completely ignored the extenuating circumstances in place during the pandemic.
Without drive-through vaccination clinics, Ma’s court submissions said, she would have had to lease a large space for a “physical office.” Ma argued the rule is from a bulletin that shouldn’t be relied upon “because it is twenty years old” and “is not law.”
The clinics she organized helped the government achieve its stated goal of vaccinating as many people as possible during the pandemic, she argued. The services she organized also relied on the guidance of the Ontario Medical Association (OMA), she said.
In response to the verdict, Ma, who is now required to pay $600,962.16 plus interest in ineligible claims, said in her submissions it’s “unfair” that she will not be compensated for her work organizing the drive-through vaccination clinics.
“The Appeal Board acknowledges the efforts made and results achieved by Dr. Ma in organizing clinics to facilitate vaccinations of so many in her community,” the ruling states.
“However, the Appeal Board does not have the discretion to ignore the requirements of the Act and the Regulation including the Schedule of Benefits. For the reasons set out above, the Appeal Board finds those requirements were not met.”
