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Pleasant Hill Plaza Medical Centre:  Fraud Verdict

Upcoding Ups Income by Factor of Four

Letter from College of Physicians and Surgeons of Saskatchewan

Clinic Ordered to Reconsider Billing Tactics for Allergy Shots



Direct all correspondence
to the Registrar

College of
Physicians and Surgeons
of Saskatchewan


Business: (306) 244-7355
Facsimile: (306) 244-0090

OUR FILE: Howlett, E.

Mrs. Georgena S. Sil,
P.O. Box 1491,
S7K 3P7

Dear Mrs. Sil:

I have now concluded my investigation of your concerns raised in your letter of October 22nd, 1996.

A reply was received from the Pleasant Hill Plaza Medical Centre through Dr. E.J. Howlett. Dr. Howlett has indicated that in their Clinic the physicians provide the injection rather than a nurse. He states that the physician is responsible for:

  1. Assessing the patient with regard to recent reactions and current health status.
  2. Ensuring that allergen extract has been stored properly and that it is not outdated.
  3. Determining the appropriate dosage of extract to be given at that particular visit; prearranged dosage schedules are frequently modified.
  4. Assessing the potential for misadventure. Example: infection at puncture site, bronchospasm in asthmatics.
  5. Acceptance of the medical/legal risk involved with injecting a foreign substance.

In addition, when you come to the office you are registered, the computer record is accessed by the office staff and the chart is pulled from the filing bank. After the injection the patient is observed in the waiting room for a time to determine if there were ill effects related to the injection. Dr. Howlett has indicated that in view of the above, they believe that a 5B fee is reasonable.

I have indicated to Dr. Howlett that he should reconsider this and discuss the matter with the Saskatchewan Medical Association which is the economic arm for physicians in the province. I have been awaiting his reply after he consulted Dr. Scharfstein, but have not received it. Therefore, I am sending this letter, with a copy to Dr. Howlett, to remind him that I am still awaiting his reply.

Sincerely yours,

L.M. Loewen, M.D.
Deputy Registrar


cc: Dr. E.J. Howlett
Pleasant Hill Plaza Medical Centre
1623 20th Street West
Saskatoon, SK.
S7M 0Z7

Competent caring Physicians providing quality health care.

Letter to Royal College of Physicians, Ottawa

Clinic’s Excuses for Upcoding are Disrespectful, Infuriating

Georgena S. Sil
Saskatoon, Canada
Physicist & Technical Writer
Alumnus: University of British Columbia
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Physician Payment Schedule

In Saskatchewan, the branch of government that sets the fees physicians may charge is:

Medical Care Insurance Branch
Saskatchewan Ministry of Health

The fees in effect at the time Pleasant Hill Plaza Medical Centre committed their fraud are set out in these legislative documents:

Payment Schedule for Services Provided by a Physician (1991)

MCIB:  Billing Procedures

MCIB:  List of Billing Codes

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