Toronto hospital dismisses 150 staff for alleged benefits fraud

About 150 employees at Baycrest Health Sciences have been dismissed for benefits fraud.

Last year, in the course of establishing an approved provider network for its employee benefits, the Toronto geriatric hospital said concerns were raised about some of the extended health-care claims employees were making under the benefits plan.

“As a result, we retained a third party to conduct an audit of our employee extended health benefits plan,” said the hospital in a statement. “This audit found irregularities. We then conducted a workplace investigation which found that a significant number of employees were misusing our benefits plan over the course of a number of years.”

Read: Head to head: Who’s responsible for detecting benefits fraud?

The employees, who span a number of job categories, were dismissed for falsely claiming as much as $5 million in benefits over an eight-year period. “The costs to do the investigation, ensure adequate staffing, the process involved in rooting this from our organization is greater and we are still calculating that amount,” said the hospital.

The claims involved the misuse of prescription coverage for orthotics, knee braces, compression stockings, as well as physiotherapy.

“We are extremely disappointed by these findings as we view any misuse of our benefits plan as inconsistent with our policies and procedures and incompatible with our Baycrest values,” said the hospital. “As a result of the investigation thus far, approximately 150 people are no longer with our organization through a combination of terminations and resignations. The employees involved spanned a variety of job categories.”

In order to prevent similar benefits misuse in the future, Baycrest said it will ensure its external benefits administrator will conduct additional audits, it will set up an approved provider network and it will provide further education to its staff about the benefits, including what they’re for and what constitutes misuse of the plan.

Read: TTC condoned benefits fraud, union argues in fighting staff terminations

The National Post reported that the hospital operates its own employee benefits plan from a pool funded 75 per cent by the government of Ontario and 25 per cent from employee premiums. The plan is administered by Coughlin & Associates Ltd., which is based in Ottawa and Winnipeg.

In a similar case in 2018, the Toronto Transit Commission dismissed more than 200 employees who had connections to a multimillion-dollar benefits scam, after an investigation that started in 2014.