The audit of physician billings was launched last year after concerns were raised about one P.E.I. psychiatrist who earned over $1.13 million in fee-for-service payments in 2014.
Health P.E.I. says it sent letters on Dec. 22, 2015, to two fee-for-service family physicians and three psychiatrists advising them the health agency was “seeking recovery for amounts determined owed as a result of comprehensive audits which were conducted,” said Denise Lewis Fleming, chief operating officer for Health P.E.I.
“Health P.E.I.’s audit rights are affirmed in the Master Agreement with the Medical Society of P.E.I. The act allows for recovery of overpayments,” she added.
Physicians can appeal audit assessments, which would begin with a discussion with the executive director of medical affairs or a designate. If no agreement can be reached, the matter is appealed to the health services payment advisory committee, which would then provide a recommendation to the minister.
Health P.E.I. says it cannot release the amounts determined to be overpayments in part or in whole because specific details relating to active audits cannot be released until a settlement has been reached.
Lewis Fleming did say two of the five audits have been settled and are closed, while the other three are ongoing.
“Details related to the audit recovery amount will be disclosed as part of Health P.E.I.'s audited financial statements to be released to the public this fall during the organization's annual general meeting,” she said.
“This information will also be shared when government issues the next edition of public accounts."
Meanwhile, the most recent list of physician salaries for the year ending March 31, 2015, tabled in the P.E.I. legislature shows last year not one, but three physicians earned over $1 million in fee-for-service payments, including a psychiatrist, a family physician and an ophthalmologist.
Another two physicians — a second ophthalmologist and a plastic surgeon — made just under a million dollars in fee-for-service payments, earning $973,012 and $956,780 respectively.
It is unclear if any of those whose remuneration was close or over $1 million are among the five physicians asked by Health P.E.I. for refunds due to overpayments.
The province did table legislation during the recent sitting of the legislature to allow the names of physicians and their publicly funded salaries and payments to be released.
When the bill was tabled in April, Health Minister Robert Henderson said this would allow for more openness and transparency, especially if questions arose about a particular physician’s salary or fees.
But after the president of the P.E.I. Medical Society publicly voiced her concerns, the bill was left on the order paper.
A health department official says this was done to “allow the department more time to consult with the Medical Society regarding disclosure of information relating to remuneration to health-care providers.”
The bill remains on the order paper and could be called in the fall session of the legislature.
