Ontario: Target of Choice
The two primary sources of health insurance “gravy” were Alberta and Ontario, with the latter being the target of choice due to its extremely high and easily accessible out-of-country medical benefits. Until 1993, Ontario paid an astounding $1,500 per patient, per day, for foreign psychiatric treatment. This was then reduced to $200, but recently was raised again to $400 per day. Considering that the average daily cost to provide treatment for the elderly in the United States is $70 per person, Ontario is a lucrative target. In fact, between fiscal year 1992–1993 and 1995–1996, the Ontario Health Insurance Plan (OHIP) paid out roughly $30 million in out-of-country addiction and psychiatric treatment. There were many psychiatrists, psychologists, therapists, patient brokers, marketing agents and more who were involved in this fraud in both the United States and Canada. In addition to using advertising and other similar means to lure in unsuspecting victims, they picked up people off the streets. Diagnoses for non-existent “illnesses” were liberally issued, followed by massive billings for similarly non-existent “treatment.” Evidence of the extent of the fraud has been mounting for some time. On September 28, 1991, the Houston Chronicle reported that “Canadian officials said OHIP has paid 75% of a patient’s treatment cost, sometimes running to $1,500 a day. The new health insurance limits were enacted after the Ontario government determined OHIP may have been bilked out of millions of dollars by private U.S. psychiatric hospitals. The new limits also may stop use of ‘headhunters’ who scoop substance abusers off Canadian streets and refer them to U.S. psychiatric hospitals for bounties that can range from $1,500 to $4,000.” Numerous criminal and civil convictions have occurred over the past few years and the process is accelerating. On May 3, 1995, the President of the United States announced the launch of Operation Restore Trust, a program designed to “crack down on Medicare and Medicaid fraud.” He emphasized that “This operation builds on the success of an anti-fraud effort in Medicare that last year generated the largest federal health care settlement in history, with $379 million in government savings. It involved efforts by a team of HHS [Health and Human Services] and Justice officials, state representatives, and Medicare contractors to investigate illegal treatments of patients at psychiatric hospitals across the nation.” The program has since proved to be a success and is being expanded. Despite the fact that these psychiatric syndicates have been and are being investigated and brought under the law in the United States, many culpable individuals and organizations within Canada are slipping through the net. Apparently, the vast array of investigations, raids by U.S. law enforcement agencies, legislation, civil and criminal prosecution, settlements with victims and more, have largely escaped the notice of the Ontario, Alberta and Canadian governments.
The $400 Million Swindle continued...
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