REGINA — A former Regina family doctor found guilty last year of professional misconduct has lost most of his appeal of a $223,358 overbilling ruling after a Saskatchewan judge upheld key findings against him.
The Regina Court of King’s Bench found Saskatchewan's Joint Medical Professional Review Committee (JMPRC) acted reasonably in concluding Dr. Imafidon Thomas Izekor billed for unnecessary visits, used improper codes, and kept documentation too sparse to verify what services were provided.
“Dr. Izekor billed for appointments that were clearly not medically necessary; it was reasonable to conclude he overbilled in the manner which the JMPRC identified,” said Justice Andrew S. Davis in his Feb. 27 written decision.
The ruling stems from a 15-month review of Dr. Izekor’s billings between 2016 and 2017, during which the JMPRC found he routinely charged for visits that were unnecessary or improperly coded. The panel concluded his records were so minimal that it couldn’t verify what services were actually provided.
“He failed to document many patient consultations in more than the most minimal fashion,” said Justice Davis.
The committee reassessed his payments, reducing his total billings from $905,669 to $682,311 and ordered repayment of $208,356, plus an additional $15,000 for improper use of public funds. Justice Davis upheld those findings, saying Dr. Izekor often conceded during the hearing that his documentation was inadequate and that he had billed for uninsured services, including filling out forms and routine INR (International Normalised Ratio) services handled over the phone.
The court rejected arguments that the JMPRC applied an inconsistent definition of medical necessity or placed an unfair burden on the doctor to justify his claims. Justice Davis said that the onus properly rests with physicians to demonstrate entitlement to public payment and that the committee was entitled to rely on missing or incomplete records when assessing whether a service was medically required.
But the judge found a flaw in how the committee extrapolated its findings. The JMPRC reviewed a sample of patients who saw Dr. Izekor frequently and applied those results across his entire patient population, including individuals he saw only once or twice. Justice Davis ruled the committee didn’t provide adequate reasons to justify applying the same error rate to infrequent-visit patients and ordered that portion of the decision sent back for reconsideration.
All other grounds of appeal were dismissed, leaving the repayment order and the committee’s findings on documentation and medical necessity intact.
Guilty of misconduct
Last year, Dr. Izekor was found guilty of professional misconduct after a disciplinary hearing by the College of Physicians and Surgeons of Saskatchewan (CPSS).
Dr. Izekor was found guilty of two charges of sexual impropriety involving female patients – one was a minor – and one charge of disrespectful and unprofessional communication with clinic employees.
The CPSS disciplinary committee determined that Dr. Izekor failed to maintain appropriate professional boundaries during appointments with a 19-year-old and a 16-year-old patient in 2018.
Case followed by Alberta regulator
The case has also drawn attention from Alberta’s medical regulator. In a January statement, the College of Physicians and Surgeons of Alberta (CPSA) said it had been “closely following” the Saskatchewan proceedings and understood the penalty in that province had been stayed pending an appeal.
CPSA confirmed Dr. Izekor remains active in Alberta but must have a CPSA-approved chaperone physically present for all interactions with female patients.
“If a chaperone is required as part of a practice condition, they must have gone through specialized training and CPSA approval to ensure they are protecting the interests and well-being of patients,” said the regulator in a Jan. 27 statement.
The Alberta regulator said it will continue monitoring the outcome of the Saskatchewan appeal and take any further action required to protect patients.
