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By Lisa Schick, CJME News

Saskatoon pharmacy disciplined for overbilling Indigenous Services Canada

Feb 1, 2023 | 4:16 PM

After the pharmacy manager blew the whistle, SRx Pharma Inc. — which runs a pharmacy in Saskatoon — has been found guilty of misconduct.

According to the discipline documents from the Saskatchewan College of Pharmacy Professionals, in 2017 and 2018, the pharmacy overbilled the non-insured health benefits program (NIHB) to the tune of thousands of dollars for hepatitis C medication.

The NIHB is a program under Indigenous Services Canada (ISC), which provides eligible First Nations and Inuit people with coverage for a range of things including prescription medication.

The pharmacy was accused of not only submitting billing for the medication higher than was paid, but also for having the drug wholesaler change invoices to match the inflated billing.

The hearing documents say the pharmacy manager was pressured into these things by the president of SRx, Adesh Vora. The manager eventually quit and made a complaint to the college.

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According to the discipline decision, Vora told the pharmacy manager that other pharmacies of his did the same thing. Vora had got an oral caution from the Ontario College of Pharmacists for, among other things, improper billing practices to NIHB for hepatitis C medication.

When ISC got wind of the overbilling, it directed a forensic audit be done. It found that NIHB may have been overcharged between $73,795.40 and $265,458.28.

ISC demanded the money back from the pharmacy company and the $73,795.40 was paid.

The decision, written by Michael Davis, chairperson of the Discipline of the Saskatchewan College of Pharmacy Professionals, said the committee was “acutely aware” of the context of the misconduct.

“SRx exploited a government initiative designed to improve access to health-care services for First Nations and Inuit peoples who have been subject to injustice and discrimination in Canada and who continue to face substantial social and economic disparities, including in relation to health services,” read the decision.

“The Discipline Committee finds that an appropriate sanction in the circumstances should reflect the nature of SRx’s egregious and unethical misconduct and resolutely denounce any similar misconduct.”

Vora and SRx, through their lawyer, admitted the substance of the allegations and came up with a joint submission for the penalty which was accepted by the committee: A reprimand, a $30,000 fine, and paying the costs of the investigation and hearing, which amounted to another $25,875.