Ontario Needs to Take Pharmacy Fraud Seriously

Share This Post

ontario fraud

How would you react if you find out that a substantial part of the tax you?re paying goes to fraud each year? It sure leaves a bad taste in the mouth, eh?

Pharmacy Fraud in Ontario

Pharmacy fraud is a bitter reality in Ontario same as other types of fraud that have proliferated over the years. And with health-related fraud cases on the rise causing a huge loss in taxpayer money, shouldn?t it be time for the proper authorities to act promptly?

A recent report shared that the Ministry of Health and Long-Term Care was able to recover around $5 million per annum from its pharmacy inspections, bringing to light how much more we?re losing to pharmacy fraud. In fact, estimates place it at more than $100 million a year!

If only we can find a way to put an end to pharmacy fraud in Ontario, our healthcare system will be better funded without having to raise taxes. This is a nice thought, but will only be possible if the province will really take a more active approach in dealing with the abuse in the current public drug plans.

The Real Cost of Fraud

According to Canadian Life and Health Insurance Association fraud prevention specialist Karen Voin, the current estimate for Canadian health care dollars that goes to fraud is at between 2% and 10%. That?s a huge sum of money because even just 2% of Ontario?s $5.9 billion that is allotted for the public drug plan system is a whopping $118 million! That means that between $118 million to about $600 million of our health care dollars goes to fraud!

Another alarming fact regarding the above is that tax money lost to fraud is expected to rise further. This is because Ontario now offers free prescription medications to people who are 24 years old and under.

Although the province is trying to recover some of the losses, the $5 million it is able to recover through audits and pharmacy inspections are mere peanuts compared to what we lose on an annual basis.

Call for Stricter Measures

A huge factor as to why pharmacy fraud is able to continue is because the province isn?t reporting cases to the police right away and have no concrete procedure in place to make sure that money is paid back. Another reflection of this passive stance against fraud is that those who abuse the system are often able to keep their licenses and continue doing what they?re doing.

Case in point, when the office of the auditor general found out in 2015 to 2016 that $951,900 worth of prescriptions have been paid for individuals who have long passed away, the ministry records showed that they were only able to retrieve $42,365.

This is not to say that all of this is a result of pharmacy fraud, as there are cases of care facilities just failing to inform pharmacies when someone has passed away. Still, crooked pharmacists also use this to keep billing because they know that they can simply excuse this as an error when found out.

There are many more similar issues and other reasons why pharmacy fraud is becoming a bigger cash cow for fraudsters. It doesn?t help either that punishments are usually not severe enough to deter would-be-fraudsters from engaging in shady practices.

Tired of letting fraudsters get away? You can help stop fraud by reporting cases you know of to the proper authorities and being active in fraud prevention. We can help you. Talk to us about safety measures to prevent fraud today!

More To Explore


8 Tips for Preventing Employee Fraud and Theft

Have you ever been the victim of employee fraud or theft? If so, you are not alone. A significant percentage of business revenue is lost yearly to employee theft. This loss is more significant in smaller organizations and should be addressed as soon as possible to mitigate losses. A working environment that discourages fraud and theft is key, and can easily be achieved by following these 8 tips.


How Private Investigators Save Businesses and Lawyers Money

The work of a private investigator can seem mysterious to many people. Whether you picture film-noir detectives or Sherlock Holmes, the details behind their work are usually unclear. However, for lawyers, insurance companies, or employers with investigative needs, understanding the value of a reputable private investigation agency can translate into significant cost savings.