Evidence of meeting #37 for Health in the 39th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was contract.
A recording is available from Parliament.
5:10 p.m.
Bloc
5:10 p.m.
Bloc
Luc Malo Bloc Verchères—Les Patriotes, QC
Thank you, Madam Chair.
I admit that you're a woman of your word, since you're letting me ask the question I wanted to ask in the previous round of questions.
According to the Auditor General, at a given moment, there weren't any guidelines on how Health Canada was carrying out its product audit and analysis mandate. She also said there was a lack of funding at certain stages of the process. In light of that information, I think we are justified in wondering whether products that have not been rigorously reviewed may have been included among the products now on sale.
We were also justified in wondering — as Ms. Brown asked in another way when she spoke — whether certain products currently on sale are checked in a systematic, rigorous and ongoing manner. I'm thinking in particular of silicone breast implants concerning which — you'll remember this, Mr. Yeates — we raised a certain number of very important questions for Canadian women at the committee's last meeting on Monday.
5:10 p.m.
Assistant Deputy Minister, Health Products and Food Branch, Department of Health
I guess that's over to me. Thank you for the question.
We take our role to review health products extremely seriously. Our role is to do pre-market reviews. If we feel that the risk profile of a product is such that the risks outweigh the benefits, we will not approve it. That's what we do every day.
We may decide that we need to impose certain conditions on a product—that is the case with silicone breast implants—do follow-up studies, and so on. As you will recall from earlier this week, we also took four years to do that review. So we feel we did an extremely thorough job of that. We take the time we feel is necessary to do a proper and thorough review of the product submissions that are made to us. They are not allowed on the market until that review has been completed.
5:10 p.m.
Bloc
Luc Malo Bloc Verchères—Les Patriotes, QC
Consequently, despite the Auditor General's findings, you conclude that 100 percent of the products currently on the market have been thoroughly reviewed?
5:10 p.m.
Assistant Deputy Minister, Health Products and Food Branch, Department of Health
All of the products for which we have pre-market approval responsibility have been reviewed. That's what we do.
5:15 p.m.
Bloc
The Vice-Chair Bloc Christiane Gagnon
You may continue for another minute if you wish. Otherwise we won't be able to alternate. Some committee members have told us they didn't have any more questions.
If Mr. Martin, Ms. Gallant or any other person wants to come back with a question, I'll take note of the speaking order.
So Ms. Gallant will speak after that.
Mr. Martin, do you want to come back?
Mr. Malo, would you like to continue for one minute?
5:15 p.m.
Conservative
Cheryl Gallant Conservative Renfrew—Nipissing—Pembroke, ON
Thank you, Madam Chair and witnesses.
I would like to address the rest of my questions to Mr. Potter.
Most insurance companies approve major treatments through advance submission of X-rays, rather than after the fact. I know you're not in the insurance business, but I might suggest that part of remedying the situation with verification might be to go through the advance verification, rather than sending auditors out to scour through patients' private medical information after the fact, and using the power of the federal government to do so.
The onus of treatment verification on the part of the contractor is still somewhat troubling, because that is something they should be doing anyhow as part of their contract, rather than the contractee having to expend resources to do what was already supposed to be in the contract.
At the end of your answer you stated that any moneys found owing by the providers or the pharmacies were repaid to the consolidated revenue fund. Do you have any idea how much that amounted to?
5:15 p.m.
Assistant Deputy Minister, First Nations and Inuit Health Branch, Department of Health
From 1999 to March 31, 2006, based on 905 audits of pharmacies and dental and medical suppliers, we identified and recovered $4.4 million, which was repaid to the consolidated revenue fund.
5:15 p.m.
Conservative
5:15 p.m.
Assistant Deputy Minister, First Nations and Inuit Health Branch, Department of Health
It was a question of whether or not there was a valid bill. For example, we expected to see a claim to First Canadian Health, which was paying on our behalf, for a prescription. When we visited the pharmacy, we expected that they could show us that a prescription of client X was on their books and from their own records that the pharmaceutical product they dispensed was actually dispensed. I think that was a reasonable expectation.
We don't do this with every client. As I said, there are 15 million every year, and I know there are tens of thousands of different pharmacies and dental providers. So we've done 905 audits. These audits are done on a risk basis, so there is profiling that takes place by the supplier. Then we only look into those cases where we think there are questions.
5:15 p.m.
Conservative
Cheryl Gallant Conservative Renfrew—Nipissing—Pembroke, ON
Just in closing, one of the concerns explained to some parliamentarians by the providers was that when a treatment was performed yet billed the following day—because some offices close their books earlier in the day, and then treatments are posted to their books the following day—for the treatments where the day of treatment did not match the day of billing they were required to repay that money. I just want to bring that to your attention.
5:15 p.m.
NDP
Pat Martin NDP Winnipeg Centre, MB
Thank you, Madam Chair.
I'm still doing the math on some of the claims where no documentation was provided. The Auditor General looked at 154 invoices, I think.
Was it randomly? Is that how the audit was conducted?
And 22 of those had no documentation to support the volume of claims processed. It's actually a pretty high percentage. I don't know what it is, but it's about 15% or 20% of the total volume. If you extrapolated that, on a volume of $2.6 billion total, 20% of it is $500 million or something. It's really huge.
These 22 invoices totalled $5.5 million. They're like $250,000 invoices. This wasn't one dental claim or one drug claim; they're $250,000 each, on average. That stopped in 2003, I understand. But between 1997 and 2003, there could have been people billing wildly; there could have been the rampant abuse that my colleague—I thought Dave Batters was overstating things, frankly, but in reading these statistics—Do we know whether these billings—?
5:15 p.m.
A voice
She already answered. Ms. Cartwright, say it again for him.
5:15 p.m.
NDP
Pat Martin NDP Winnipeg Centre, MB
I must have nodded off for a moment, then.
So we have tracked all of that money—of those 154, at least?
5:20 p.m.
Associate Deputy Minister, Department of Health
We have verified that all $2.6 billion expended under NIHB has been spent on legitimate and appropriate medical services and products.
5:20 p.m.
Associate Deputy Minister, Department of Health
We have gone through a laborious process, which has taken us a considerable amount of time—
5:20 p.m.
Associate Deputy Minister, Department of Health
Yes, and since we uncovered ourselves some weaknesses in our management processes in 2003.
We have established, through service providers and First Canadian Health, that all of the $2.6 billion was spent appropriately.
5:20 p.m.
NDP
Pat Martin NDP Winnipeg Centre, MB
Then, Madame Dubé, have you now seen the documentation for the 22 invoices that had no documentation, and are you satisfied that they were—?
5:20 p.m.
Principal, Office of the Auditor General of Canada
No, we have not gone back to see whether they found documentation or not.