Dr. Elaine Ma administers a vaccine during a drive through COVID-19 vaccine clinic at St. Lawrence College in Kingston, Ont., in January, 2022.Lars Hagberg/The Canadian Press
An Ontario doctor who has been ordered to pay back more than $600,000 to the province for improperly billing for COVID-19 vaccinations argued in court on Tuesday that the decision should be reversed.
Elaine Ma, a Kingston-based family physician, helped thousands of people get shots during the height of the COVID pandemic by organizing drive-through vaccination clinics. She has been called a “hero” for her work and was recognized in 2021 by the Ontario College of Family Physicians with an Award of Excellence.
About a year later, Ontario’s Ministry of Health audited Dr. Ma’s claims to the Ontario Health Insurance Plan and concluded she wrongly received payments owing to the location and staffing of the clinics. In November, 2024, the Health Services Appeal and Review Board, an independent tribunal, said Dr. Ma did not follow the rules and ordered her to reimburse nearly $601,000 plus interest to OHIP.
Dr. Ma, in an interview following her judicial review hearing at the Ontario Divisional Court, said she sat in disbelief as the case was argued back and forth in the courtroom on Tuesday.
“I don’t regret running these clinics, even if the ruling is against me,” she said. “But I won’t be stepping up in the future, because I can’t afford that. I can’t afford to sacrifice my family’s financial future for that.”
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A decision by the court was not immediately released.
Many in the medical community have come to Dr. Ma’s defence, including the Ontario Medical Association, which has urged the provincial government to dismiss the allegations. Ted Hsu, the Liberal MPP for Kingston, has also publicly supported her.
When the Omicron wave was surging across Canada, Dr. Ma worked with medical students and volunteers to get more than 35,000 needles in arms at outdoor clinics around Kingston, including at St. Lawrence College and Richardson Stadium. The initiative took place between July, 2021, and January, 2022.
Dr. Ma said she used the funds to cover the cost of staffing and running the clinics. She said, at the time, she felt a duty to step up for her community.
“We were literally told people are going to die if you don’t do this,” she said. “That’s what I was focused on. It wasn’t whether OHIP could later find technicalities that we don’t agree about.”
The Ontario government raised concerns with Dr. Ma’s billing process, specifically regarding the location of her work and who was performing the services. OHIP, citing a bulletin from 1989, which was amended in 2001, stated that compensation only applied to work performed inside a physician’s office and medical students were ineligible for payment.
Dr. Elaine Ma helped thousands of people get shots during the height of the COVID-19 pandemic by organizing drive-through vaccination clinics such as this one in Kingston, Ont., in December, 2021.Lars Hagberg/The Canadian Press
Dr. Ma said, during the Tuesday hearing, much of the debate centred on whether OHIP could exercise discretion in this case. Dr. Ma said Ontario argued it did not use discretion because there was not an extenuating circumstance.
“What is an extenuating circumstance, if not a global pandemic?” she asked, adding that her case will have a chilling effect on other medical professionals, potentially hindering them from stepping up in the case of another health crisis.
The Health Services Appeal and Review Board, in its decision, said Dr. Ma “had the time and the obligation to inform herself appropriately about billing matters” even though the clinics took place during a public-health emergency.
Ema Popovic, a spokesperson for the Ontario Ministry of Health, said in a Tuesday statement that new fee codes were created during COVID for vaccinations, including for shots issued at vaccine clinics hosted by hospitals or public-health units.
Ms. Popovic said all doctors who hosted vaccination clinics - with the exception of one - used the special code. She did not mention Dr. Ma by name.
“Any physician who failed to follow the ministerial order or incorrectly paid staff, needs to return any improperly collected fees to the ministry,” she said.
With files from The Canadian Press