Dr. Elaine Ma, the lead physician of Frontenac Doctors in Kingston, organized drive-in vaccination clinics in several parking lots in Kingston from January 2021 to January 2022 to vaccinate thousands of Canadians. She recruited undergraduate medical students from nearby Queen's University as volunteers to administer a total of 27,250 doses of COVID-19 vaccines.
In line with this, Ma billed the Ontario Health Insurance Plan (OHIP) CA$606,657.6 ($432,775.5), based on Ontario's reimbursement policy of CA$13 ($9) per vaccine dose, with an additional CA$5.6o ($4) for appointments focused solely on vaccination. (Related: Jury awards $12m to Catholic remote worker who was fired for refusing COVID-19 vaccine.)
However, the General Manager of the OHIP argued that Ma did not meet the conditions to qualify for the reimbursement policy. For instance, the individuals who administered the vaccines were not Ma's employees, a condition required for reimbursement. Additionally, the vaccinations were not administered in a physician's office, a violation of "delegated services" in the province. Meaning, Ma improperly claimed over CA$600,000 from the OHIP.
"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. 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," the Ontario Health Services Appeal and Review Board wrote in their ruling on Nov. 26.
In turn, the board ruled that Ma should repay CA$600,962.16 ($428,209.58) to the OHIP: "Pursuant to section 6 of the Schedule 1 of the Act, the Appeal Board orders the Respondent to reimburse OHIP the amount of $600,962.16 and pursuant to section 21(5) of the Act, that interest be added to the above-noted reimbursement amount from Sept. 29, 2023 (the date of the request for a hearing by the GM)."
Ma slams the ruling of Health Services Appeal and Review Board
Ma has claimed that she was not surprised by the ruling, but she felt disappointed.
"It's really still just disbelief that we've completely forgotten about COVID," she said in an interview with CTV News Ottawa on Dec. 2. "We've completely forgotten what we were asked to do. We've completely forgotten the fact that we were asked to do it in new and different ways, and quickly, and as fast as possible. We've completely forgotten that the Ministry of Health provided a per-shot vaccine code, and that was what was billed. It wasn't anything over that. It was the amount of money that they allocated for those shots to be given."
Ma also insisted that she used the funds to run the clinics, therefore, she cannot pay back the amount.
"It wasn't an amount of money that I received. Yes, I received it, but a lot of it then turned around and paid to run these clinics. So, do I have this amount of money sitting around, just waiting to get back to OHIP? No. Further, that will mean that I have actually paid to vaccinate 36,400 people in our community, out of pocket, at my expense," she said.
Furthermore, Ma argued that the strict interpretation of "physician's office" and "employee" was based on outdated guidelines. She maintained that involving medical students and residents was standard practice and necessary to meet the demands of the public health emergency.
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