The Discipline Committee heard this matter on December 6 to 7, 2017. On December 8, 2017, the Committee delivered a written order finding that Dr. Ranjit Kumar Chandra committed an act of professional misconduct, in that he has failed to respond appropriately or within a reasonable time to a written inquiry from the College, and in that he has engaged in conduct or an act or omission relevant to the practice of medicine that, having regard to all of the circumstances, would reasonably be regarded by members as disgraceful, dishonorable, or unprofessional, with written reasons to follow. The Committee ordered that penalty be heard on December 14, 2017.
At the conclusion of the penalty hearing, the Committee reserved its decision. On June 18, 2018 the Discipline Committee released its written reasons on finding and its written decision and reasons on penalty.
Dr. Ranjit Chandra is a pediatrician who has been a member of the College since 1994. He has been practising in the field of allergy medicine in six locations.
Scheme to Defraud OHIP
In March 2016, while investigating another physician, College investigators noted unusual billing patterns and referral sources regarding Dr. Chandra’s billings. Several weeks later, the College received a complaint from a patient, Patient A, who had seen Dr. Chandra on one occasion. Patient A testified that Dr. Chandra asked her to participate in a fraudulent billing scheme using her health card number and those of her family for services he had not provided.
Patient A also heard Dr. Chandra approach other patients to the same effect. She contacted the police and then notified the College. Three other patients testified at the hearing and the Committee considered detailed documentary evidence including OHIP records, Dr. Chandra’s banking records from the Royal Bank of Canada, Dr. Chandra’s records from Roger Communications and Bell Canada, as well as e-mail correspondence from computers that were seized by the College.
The evidence demonstrated that Dr. Chandra recruited approximately 300 people to this scheme and $2,056,342 in OHIP fees were paid to Dr. Chandra over four years.
The Committee concluded that Dr. Chandra had engaged in a fraudulent scheme to defraud OHIP. It had direct evidence from Patient A who had been approached by Dr. Chandra to participate in the scheme and had been offered money to allow the fraudulent use of her OHIP card and that of her family members. The Committee also had direct evidence from two patients (Patients B and C) who had received payments from Dr. Chandra for their participation in this scheme, both of whom testified that they had received no treatment at all for the vast majority of the services for which Dr. Chandra billed OHIP. The Committee also heard from Patient D, who testified that Dr. Chandra had billed OHIP for many services for which he received no treatment.
The evidence of the investigator and the documentary evidence demonstrated that these incidents were part of a pattern of conduct by Dr. Chandra, over at least a four-year period, with significant sums of money being paid by Dr. Chandra to patients he designated as “leaders” or as receiving “extras.” The Committee found the evidence demonstrated that Dr. Chandra used these terms to refer to patients who permitted the use of their health cards in return for a portion of Dr. Chandra’s OHIP billings. The evidence indicated that the largest payments were made to employees or former employees of Dr. Chandra. The evidence also demonstrated that Dr. Chandra billed for audiometry and pulmonary function tests, despite there being no such equipment in his offices. There were no charts for multiple patients for whom he billed, and even for those patients with charts, the medical notes did not support the vast majority of the billings.
There were suspicious bundling of billing codes of increasing frequency, an unusual pattern of billing for services in bulk going back up to six months, and an unusual cluster of billings by household. The evidence further demonstrated that Dr. Chandra had billed OHIP for services ostensibly performed on dates when Dr. Chandra was not in the country. Also, there were Royal Bank of Canada records including cheques made out to specific individuals from Dr. Chandra’s medical professional corporation, who were participating in the recruitment of individuals who were to be billed as patients, classified as “leaders”, who were to bring in others, classified as “extras”, with lower levels of recruits. There were also regular patients who were unaware that their OHIP numbers were used to bill for multiple services that did not take place. While much of the evidence in this regard was circumstantial, the Committee was satisfied that it demonstrated a fraudulent scheme by Dr. Chandra to defraud OHIP, a conclusion supported by the direct evidence of Patients A to D and the documentary evidence.
The Committee concluded that Dr. Chandra engaged in a systematic scheme to defraud OHIP by submitting false claims and that he enlisted some of his patients in this scheme. The Committee found that such conduct constitutes an act relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.
Failed to Respond to Written Inquiry from the College
The Committee found that during its investigation, the College wrote to Dr. Chandra over a six- month period from July 5 to December 12, 2016, requesting that he attend for an interview, either in person or by telephone, and provide certain information and reminded him of his duty to cooperate with the College’s inquiries. Dr. Chandra declined to attend an interview and to provide the requested materials.
Paragraph 1(1) 30 of O. Reg. 856/93 provides that failing to respond appropriately or within a reasonable time to a written inquiry from the College is an act of professional misconduct.
Subsection 76 (1.1) of the Code states that an investigator may make reasonable inquiries of any person, including the member who is the subject of the investigation, on matters relevant to the investigation. In addition, subsection 76 (3.1) of the Code provides that a member shall cooperate fully with an investigator.
The Committee found that Dr. Chandra’s willingness to “consider” the College’s request for an interview only after he received a complete copy of the documents in the College’s possession is a position which overtly challenges the authority conferred upon the College and undermines the College’s ability to safeguard the public. It is not for the subject of the investigation to dictate the manner in which the College gathers information or to otherwise control the sequence or timing of the investigatory process. The College has a duty to serve and protect the public interest, and in doing so, to choose the timing and means of investigation that are most likely to determine the truth and protect the public.
The duty of members to respond is a statutory one and there are no exceptions. It is an essential tool for the College to fulfill its primary objective of protecting the public interest. There is no statutory requirement for the College to release investigative material at the interview stage. The Committee notes that by the time the interview was being requested, there was a high degree of suspicion of fraudulent behaviour and the investigator needed to be able to address specific questions at an interview. The Committee concluded that it was reasonable for the College to refuse further disclosure before conducting an interview with Dr. Chandra. Accordingly, the Committee did not accept the position advanced by Dr. Chandra’s counsel at the time in correspondence that Dr. Chandra was entitled to refuse to be interviewed by the College until his demands for full disclosure were met. The Committee found that Dr. Chandra was required to meet with the College investigator and provide the information requested, and that his failure to do was a breach of his obligation to respond appropriately or within a reasonable period of time to a written inquiry of the College.
The Committee also concluded that a pending criminal proceeding is no basis for a member to refuse to be interviewed or to otherwise refuse to co-operate with the College’s investigation.
The case law demonstrates that the criminal courts are sensitive to the fact that members of a regulated health profession are required to provide statements to their regulators and can and do protect the member’s Charter rights.
The Committee found that Dr. Chandra failed to respond appropriately or within a reasonable time to a written inquiry from the College.
The Committee also found that Dr. Chandra’s failure to respond within a reasonable time to the College’s written inquiry was an abrogation of his professional duty and constitutes an act relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.
Disposition
The Discipline Committee ordered and directed that:
The Registrar revoke Dr. Chandra’s certificate of registration, effective immediately.
- Dr. Chandra pay a fine to the Minister of Finance in the amount of $35,000.
- Dr. Chandra shall appear before the Committee to be reprimanded.
- Dr. Chandra pay to the College costs in the amount of $16,500 within 30 days of the date of this Order.
