Public health specialist wins 25 year battle over patient billing
Serge Lecours was granted $155K in damages
CBC News
Posted: Dec 28, 2012 4:41 PM ET
Last Updated: Dec 28, 2012 8:14 PM ET
The Quebec Superior Court said the province's health insurance board failed to complete a proper investigation. (IStock)
A doctor's battle with Quebec's health insurance board has finally come to an end after 25 years.
Dr. Serge Lecours, who helped pioneer public health and toxicology as a medical specialty, was awarded $155,000 in damages after the Quebec Superior Court upheld a lower court's decision.
Lecours was one of the first physicians in Quebec to be certified as a specialist in public health and toxicology.
Lecours came to the board's attention in the 1980s because of his billing pattern. It noticed Lecours was billing his patients almost exclusively as a medical specialist.
At the time, the board said public health specialists billed nearly half their cases as specialists and the other half as general practitioners.
The board ultimately accused Lecours he was falsifying his bills, despite the fact the court heard that in-house doctors never examined any of his patients' files or consulted outside experts.
A physician for the insurance board testified he used common sense to determine the bills were falsified. The Quebec Court of Appeal said the board and its in-house experts failed to conduct a proper investigation.
The court ruled the insurance board had abused its powers when it demanded to be reimbursed half of the fees Lecours had been paid over a two-year period.
Lecours had originally asked for $655,000 in damages but the court awarded a lower sum, based on the Court of Appeal's ruling last June, because it said Lecours waited too long to take action.
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