Pharmacy chain fined $30K after Saskatoon pharmacist flagged overbilling of Indigenous Services Canada

The pharmacy chain SRx Pharma has been fined $30,000 for overbilling Indigenous Services Canada for drugs used to treat hepatitis C, after a Saskatoon pharmacist alerted the province'sregulatory body to the practice.

It's the largest fine ever handed out by the Saskatchewan College of Pharmacy Professionals, the regulatory body for pharmacists in the province, according to a written decision from a college disciplinary committee.

The overbilling involved marking up hepatitis C drugs over the maximum allowable provincial prices and altering invoices, according to the decision, dated Dec. 27.

It was brought to the attention of the college when the pharmacist at SRx Pharma's Saskatoon location lodged a complaint with the college.

In December 2017 the pharmacist referred to only as DM in the decisioncontacted the college's complaints director with concerns about the billing practices at SRxand the directions he was receiving regarding billing forpatients receiving hepatitis C medications though the Non-Insured Health Benefitsprogram, or NIHB.

That federal program provideseligible First Nations and Inuit clientswith coverage for a range of health benefits that are not covered through other insurance or social programs.

The pharmacistresigned from SRx Pharma in January2018, and fileda complaint with the collegeregarding the billing practices at SRX in February of that year.

A later forensic audit by Indigenous Servicesfound the departmenthad been overbilled between $73,795.40 and $265,458.28, the written decision says.

The departmentdemanded SRx Pharma repay $73,795.40, which it did, according to the decision.

Pharmacist commended

At a college disciplinary committee hearingin late November 2022, SRx pleaded guilty to the accusation ofproprietary misconduct.

Thedisciplinary committee found SRx Pharma directed the pharmacist to submit claims and invoices to Indigenous Services at the maximum allowable costs for pharmaceutical products used to treat hepatitis, when the actualcosts for those products were substantially less, the decision reads.

Hepatitis C is a viral infection that affects a patient's liver.If left untreated, chronic hepatitis C can cause serious complications, such as liver failure and liver cancer.

It can be treated through medication, but the cost for those medications can be significant.

The Saskatchewan pharmacy college's decisionsaid the the president of SRx Pharma, Adesh Vora, directed the pharmacistto "contact the drug wholesaler to have the invoices altered to match the NIHB maximum allowable cost of the prescription product."

The pharmacist was also told to submit these claims and invoices when the company knew or ought to have known that the claims and invoices were misleading, according to the decision.

It says the "companyprovided false and misleading information to the pharmacy manager DM regarding the billing processes of the NIHB Program."

"You interfered with and did not allow the pharmacy manager DM to exercise their authority and responsibility in operating the pharmacy and specifically, in managing the billing processes of these pharmaceutical products."

The decision also said the pharmacist, who was "an unwilling participant in SRx's misconduct," was to be commended for bringing the issue to the college's attention.

"The discipline committee notes that, but for DM's actions, SRx would likely have been permitted to continue its deceitful billing practices," the decision read.

Along with the fine, the college ordered SRx Pharma to pay more than $25,000 in court costs.

CBC has contacted SRx with a request for comment.

CBC also asked Indigenous Services Canada for comment, but was told no one from the department could immediately provide a response to the decision.