‘Prolonged deceit’: Doctor who set up pharmacy for fraudulent billing scheme gets 12-month suspension

An Ontario doctor who conspired with a pharmacist to fraudulently bill the public drug benefits program through a pharmacy established solely for this purpose has been suspended from practice for 12 months and ordered to pay $6,000 in college costs. Dr. Tiffany Czilli, a family physician in Windsor who was also a registered pharmacist in Ontario until October 2022, “knowingly established a pharmacy with no intent to serve the community but simply to enable your false billings,” according to a reprimand delivered by videoconference by the Ontario Physicians and Surgeons Discipline Tribunal. As part of her fraudulent billing scheme—where she invoiced for medication reviews that were either not done or were non-compliant—Dr. Czilli also gathered Ontario health insurance numbers from family members who accompanied patients to her clinic and used these numbers to submit false claims to the Ontario Drug Benefit program. She carried out the scheme for two years with the help of a pharmacist named Colin Peters, whom she was supposed to be monitoring as part of conditions imposed on him by the Ontario College of Pharmacists. Read: Banned for a year: Pharmacist claimed fear of getting infected by doctors made him forge 50 prescriptions Dr. Czilli was suspended for a year from pharmacy practice in October 2020 and banned from owning or managing a pharmacy. She gave up her pharmacy registration two years later. The cases brought forward by the Ontario College of Physicians and Surgeons and the Ontario College of Pharmacists stem from claims submitted to Ontario’s MedsCheck programs through a pharmacy she opened in April 2015. According to the pharmacy college case document, the pharmacy had no medications on site and operated initially for one hour a day before switching to only one hour a week. The pharmacy dispensed only one prescription between April 2015 and November 2015. “The pharmacy was used virtually exclusively to bill the (Ontario Drug Benefit program) for MedsChecks that were conducted by (Dr. Czilli) or Mr. Peters at the clinic,” stated the document, referring to Dr. Czilli’s medical clinic. Read: Top exec at pharmacy in deadly meningitis outbreak sentenced Together, Dr. Czilli’s and Peters conducted approximately 4,000 MedsChecks a year. Between October 2016 and April 2017 alone, Dr. Czilli’s pharmacy billed the province for 2,283 MedsChecks and got paid $115,755. But many of these medication reviews were conducted on patients who were not eligible for the program because they were not taking a minimum of three prescription medications for a chronic condition. At the same time, the reviews were completed in Dr. Czilli’s clinic and not in an accredited community pharmacy as required by the program. “Your prolonged deceit in your submissions for publicly funded payment are reprehensible,” the Ontario doctors tribunal told Dr. Czilli in its reprimand. “This was not a case of inadvertent errors in billing but a conscious plan to provide yourself with monetary gains for services you were not eligible to provide. This undermines the trust the public has in our profession.” Read: Doctor who put non-cancer patient through extensive chemo ordered to pay close to $73K

‘Prolonged deceit’: Doctor who set up pharmacy for fraudulent billing scheme gets 12-month suspension

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