Dialogue Volume 13 Issue 2 2017 - Page 57

discipline summaries ing from and giving money to the patient; creating a relationship between the patient and a personal friend of the psychiatrist; praying with the patient; creating the image that the patient was special; and, intimately touching the patient. Dr. C concluded that Dr. Glumac poses a risk to other patients, that Dr. Glumac does not have requisite skills to manage opioids, and should not be doing so. Inappropriate OHIP Billing regarding Patient A Dr. Glumac also billed the Ontario Health Insurance Plan for services he did not provide to Patient A. For example: he billed and was paid for nine sessions of psychotherapy which he did not provide, and he billed and was paid for three sessions of psychiatric care which he did not provide. Dr. Glumac either billed for services he did not provide, or failed to keep clinical records on 16 occasions. Section 75(1)(a) Investigation regarding OHIP Billing On March 6, 2015, Dr. Glumac entered into an undertaking which required, among other things, that he cease prescribing narcotics and that he video monitor all patient encounters. The Compliance Case Manager who subsequently vis- ited Dr. Glumac noted that he was conducting patient sessions over the telephone, and was billing OHIP for it. Consultations and assessments rendered by telephone (including services such as psychotherapy, counselling, primary mental health and psychiatric care), are not insured services and are not payable by OHIP. The College retained Dr. D to review Dr. Glumac’s OHIP billing. In all but one of 32 patient charts that Dr. D reviewed, he found that the OHIP bill- ing Dr. Glumac submitted failed in some way to meet the standard of practice of the profession. Dr. D observed that while many insured services were correctly billed to OHIP, Dr. Glumac billed OHIP for services that are uninsured. This suggested that Dr. Glumac understood and followed the general payment rules such as the minimum duration for time for unit based services and the time documen- tation requirements. Dr. Glumac billed OHIP for services such as telephone communication, Skype sessions, faxing prescriptions, certain reports, dicta- tions, and research on behalf of his patients. When these uninsured services were provided, there was no evidence in the charts that an accompanying insured service was provided in order to justify the billing Dr. Glumac submitted to OHIP. In addition, Dr. Glumac billed for special visit pre- miums when the visits attached to those premiums were not eligible for premiums. Dr. E, another College-appointed medical inspector who reviewed Dr. Glumac’s patient charts also noted billing irregularities. Dr. E noted that Dr. Glumac inappropriately used psychiatric care codes and psy- chotherapy fee codes to bill for other services such as report writing, communicating with third parties, and faxing prescriptions, which are uninsured services. Reasons for Penalty Counsel made a joint submission as to an appropri- ate penalty and costs order. Counsel submitted that an appropriate penalty is the immediate revocation of Dr. Glumac’s certificate of registration and a public reprimand. Additionally, it was jointly submitted that Dr. Glumac reimburse the College for funding provided under section 85.7 of the Code for therapy and counselling to the patient he sexually abused. It was further jointly submitted that Dr. Glumac pay the College the tariff cost of a one-day hearing. The Committee found that the immediate revoca- tion of Dr. Glumac’s certificate of registration was appropriate in the circumstances. Ordering immedi- ate revocation of Dr. Glumac’s certificate of registra- tion serves to express the Committee’s abhorrence of his despicable behaviour with Patient A. This also serves to maintain public confidence in the integrity of the profession’s ability to self-govern in the pub- lic interest. The public will be protected from Dr. Glumac since he has now been removed from the practice of medicine. A public reprimand will serve to denounce Dr. Glumac’s reprehensible misconduct and sends a mes- sage of deterrence to the profession at large. Dr. Glumac’s egregious blurring of doctor-patient boundaries is completely unacceptable and warrants the most severe penalty available: revocation. The Committee was disappointed that Dr. Glumac Full decisions are available online at www.cpso.on.ca. Select Doctor Search and enter the doctor’s name. Issue 2, 2017 Dialogue 57