Dr. Panayiotis Iracleous, an emergency room physician at Scarborough Centenary Hospital, has had his medical licence revoked after overbilling the Ontario Health Insurance Plan (OHIP) for more than $125,000 over a three-month period and subsequently refusing to cooperate with the subsequent investigation.
Disciplinary panel condemns conduct
In its recent decision, a disciplinary panel of the Ontario Physicians and Surgeons Disciplinary Tribunal wrote: "Dr. Iracleous took scarce health-care dollars for his personal benefit. He betrayed the trust that the Ontario public places in physicians to honestly and carefully make claims that comply with the rules. He diminished the reputation of the profession. His conduct was disgraceful, dishonourable and unprofessional."
Investigation reveals widespread fraud
According to the tribunal, the Ministry of Health analyzed 408 records from the Scarborough Health Network related to Iracleous's billings for claims made between May 1 and July 12, 2021. Investigators found no records to support any of the claims for which he had received $125,353.05 in ineligible OHIP payments. In 406 of the 408 patient records, there was no evidence that Iracleous had rendered any services to the patient.
In November 2022, the ministry requested repayment, and the doctor promptly returned the money. The province then notified the College of Physicians and Surgeons of Ontario, which launched its own investigation. The tribunal stated that an expert review of 24 charts from the emergency department revealed that in 21 of them, Iracleous did not appear to have been involved in the patients' care. Additionally, in 22 charts, he billed for services on dates when the patients were not even present.
In 23 of the charts, Iracleous billed codes that apply when a doctor has been called in from home. However, in 21 of those 23 charts, there was no evidence of his involvement in patient care or that he was on call.
Refusal to cooperate
The tribunal noted that the college requested an interview with Iracleous in 2023, but he refused. In January 2024, the investigator sent him the assessor's report and invited a written response, which he did not provide. In October 2024, the investigator asked Iracleous to answer 23 detailed questions about the reviewed charts, but he again failed to respond.
The tribunal found it particularly serious that Iracleous refused his "fundamental obligation" to cooperate with the investigation. The only mitigating factor was that he had repaid the money and entered a no-contest plea, meaning he did not admit the allegations but accepted that the uncontested facts would be used for the disciplinary hearing.
Precedent for revocation
The panel noted that intentionally overbilling OHIP has led to licence revocation for many Ontario doctors. The most recent example occurred late last year when the tribunal stripped a Pelham doctor of his licence for receiving "hundreds of thousands of dollars" for services not performed.
"The honour-based OHIP billing system is founded on public trust in the honesty and integrity of physicians. Revocation in cases like this is important to demonstrate to the public that the college requires each of its registrants to uphold that trust," the ruling concluded.
The loss of this doctor comes at a time when the healthcare system can ill afford to lose any physicians. Despite his actions, Iracleous had previously received stellar reviews online.
