Everyone loves a great deal or getting something for free, but when fraud is involved there is always a high price to pay. Fraudulent business activities are not limited to a particular industry, so we all have to be vigilant when it comes to protecting healthcare benefits.
The overall wellness of our society is drastically affected when healthcare benefits are abused. This has been sadly evident in recent news stories that shed light on various investigations throughout Toronto.
Healthcare benefits fraud in the news
July 2019 - Approximately 150 employees were either fired or resigned from Baycrest Health Sciences after allegedly defrauding their benefits insurer for several years. Employees submitted receipts for products and services not received including one person with $20,000 in false claims. The geriatic hospital initiated a third party investigation, but it’s not clear if criminal charges will follow.
November 2019 - After a lengthy investigation, the Toronto Transit Commission settled a lawsuit with their benefits insurer that involved an alleged orthotics scam. Over 250 employees were either fired or resigned with an additional 14 people being disciplined. The $5 million lawsuit was seeking damages from a scheme that allegedly included employees submitting false receipts with the insurance payout being split with a clinic.
August 2020 - A Peel Regional Police officer was charged with fraud over $5000 and forgery related to an alleged unspecified healthcare benefits scheme. The 13 year police veteran was suspended with pay and is scheduled to appear in court on October 5th.
Signs of benefits fraud
If it seems too good to be true, it probably is! Beware of clinics that offer various types of incentives with the purchase of a medical device or service. Offers of free shoes, gift cards, cash back or any kind of free merchandise is not the regular practice of a legitimate clinic or practitioner.
Clinics and/or practitioners should not be billing for products or services that have not been sold or rendered. It is also considered fraudulent to submit claims for products and services that are not medically necessary.
Podiatry, chiropody, optometry, orthotics and massage clinics are among the various healthcare disciplines that have been exposed to benefits fraud. No one is exempt, but we can all do our part by rejecting unethical and illegal behaviour. Otherwise, the consequences could be severe for anyone participating in benefits abuse, including patients, practitioners, clinics and orthotics labs. (The manufacturer)
Certified healthcare professionals making a difference
It’s been said that a business is only as good as their reputation; and, that goes for any industry. At HealthCasa, helping people reach their optimal level of health in an ethical manner is at the forefront of what we do. Our reputation is important to us, so our business model will never include dishonesty. Our team has not and will not engage in any transaction that is a direct result of deceitful incentives and methods. HealthCasa will continue to utilize certified healthcare practitioners through effective and reliable mobile healthcare.
Core values: honesty, transparency, and credibility
HealthCasa has been trusted by hundreds of families to provide customized healthcare services in the comfort of their homes. We specifically attract and hire practitioners who have the same moral ethical code to ensure our high standards remain in place. While other clinics may use questionable tactics for quick financial gains, we understand the importance of doing it right all the time.
Our regulated healthcare professionals have a solid track record of providing legitimate prescribed medical devices that never include bogus incentives. From Orthotics, Chiropody to Physiotherapy and Massage Therapy - you’re in good hands with HealthCasa.