discipline summaries
facts, though he did not plead guilty to the associated
counts, regarding billing OHIP for 17 Special Visit
Premiums related to discussions with a colleague
regarding the colleague’s personal medical issues and
11 Special Visit Premiums related to discussions with
a member of his church.
In relation to the three charges of which he was
found guilty, Dr. Opper was sentenced to a fine of
$30,000 ($10,000 per count), plus court costs and
victim surcharge. On October 25, 2012, prior to the
hearing on the charges, Dr. Opper paid restitution in
the amount of $29,816.20.
Reasons for Penalty
The Committee, after careful consideration, accepted the joint submission.
The Committee was dismayed by Dr. Opper’s
misconduct which displayed a flagrant disregard
for the privileged position of trust in society which
physicians hold. The OHIP relies on the honesty and
integrity of billing physicians to bill accurately and
in accordance with the criteria for payment set out in
the Health Insurance Act and Regulations, including
the Schedule of Benefits.
When funds are deflected to fictitious billings, there
is less funding available for the real needs of patients
in the health-care system. By his misconduct, Dr. Opper violated core values of our profession. Dishonesty
and disregard for the medical services payment system
hurts patients. Dr. Opper was found guilty of offences
contrary to the Health Insurance Act. His misconduct
involved repeated offences and occurred over a significant period of time. The Committee must impose
a serious sanction for such serious misconduct. His
misconduct reflects not only on himself but also on
the profession as a whole and may erode the public’s
trust in self-regulation by the profession.
Dr. Opper maintains that his record-keeping was
a significant problem in these billing irregularities.
The Committee emphasizes that record-keeping is a
fundamental part of patient care. The fact that there
were no records for so many patient encounters cannot
be explained away by poor record-keeping alone. The
Committee is reassured that Dr. Opper has already
taken, and successfully completed, the College approved record-keeping course and expects this will not
be a problem in the future. It is the Committee’s hope
that with the successful completion of an educational
program in ethics specifically designed for Dr. Opper, he will gain a greater understanding of why such
misconduct is particularly abhorrent. However, for
the further protection of the public, there will be
significant terms, conditions and limitations imposed
indefinitely on Dr. Opper’s certificate of registration in
the form of chart and billing monitoring with regular
reports to the College, and ongoing unannounced
inspections of his practice charts and billings.
This type of misconduct cannot be tolerated. In addition to the failures in record-keeping to justify his
billings, Dr. Opper, in certain cases, knowingly gave
false information to OHIP regarding the provision of
services and admitted to not having provided services
to patients, for which he billed OHIP. A three month
suspension of Dr. Opper’s certificate of registration
will serve as a specific deterrent and a general deterrent to the profession. It is a privilege to have an
honour system for the payment for one’s professional
services, and it must not be abused.
The Committee did consider mitigating factors
in this case. Dr. Opper cooperated throughout the
discipline process, he has already made restitution in
the full amount according to OHIP and he has paid
a significant fine as ordered by the Ontario Court
of Justice. He has expressed his embarrassment and
regret for his misconduct, and by admitting to the
allegations, he saved resources for the College in both
time and money. However, the Committee does have
the discretion to award costs in an appropriate case
and agrees with the joint submission that this is such
a case. The Committee ordered Dr. Opper to pay to
the College the tariff cost of $4,460, for one day of
hearing.
In summary, the Committee ordered the following:
a reprimand, a three-month suspension; successful
completion of an ethics program; terms, conditions
and limitations imposed indefinitely on Dr. Opper’s
certificate of registration in the form of chart and billing
monitoring with regular reports to the College; ongoing unannounced inspections of his practice, charts and
billings; and payment to the College of $4,460 in costs.
Full decisions are available online at www.cpso.on.ca.
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Issue 1, 2016 Dialogue
43