Ontario Drug Benefits Fraud Lawyers Based in Toronto, Servicing Pharmacists Across Ontario.
If you have been notified that you or your pharmacy is being audited or investigated for Ontario Drug Benefits (“ODB”) fraud, you should contact a lawyer immediately. A Ministry of Health and Long Term Care investigation can lead to a pharmacy’s loss of its billing privileges, fraud charges, and complaints to the Ontario College of Pharmacists.
The Ministry of Health and Long Term Care investigates pharmacists and pharmacy owners for ODB fraud. ODB fraud is often detected by high volumes of billings for certain pharmacy products or by random questionnaires sent to patients to determine whether they received medication that was billed by the pharmacy as being dispensed.
If the Ministry of Health and Long Term Care determines that ODB fraud has occurred, they will issue a Notice of Intention to Terminate your Health Network System Agreement, which means that your pharmacy will no longer be able to bill the ODB, effectively ending that pharmacy’s business.
The Ministry of Health and Long Term care may also refer the matter to police for provincial or criminal charges and may also make a complaint or report to the Ontario College of Pharmacists.
Pharmacy Audit Lawyers for Ontario
An audit or investigation by the Ministry of Health and Long Term Care is a complex and intense process to navigate without legal assistance. The Ministry’s Inspector will issue an audit and report, which you will have approximately 60 days to respond to. The Ministry publishes a list of pharmacies on its website for which a Notice of Intention to Terminate your Health Network System Agreement has been issued, which will result in serious harm to your business and professional reputation. Your written response is often your only opportunity to save your pharmacy’s business and to protect your billing privileges under the ODB.
Damien Frost & Associates LLP has years of experience defending Pharmacists and pharmacy owners who are being audited or investigated for Ontario Drug Benefits fraud. In a number of instances, we have been able to overturn the findings of the Ministry or negotiate a resolution that retains the pharmacy’s billing privileges under the ODB.
Let us help you by using our expertise in dealing with the Ministry. Click here to contact us if you are being audited, investigated or receive a Notice of Intention to Terminate your ODB billing privileges.
