DISCIPLINE SUMMARIES
to fulfill the terms of the Order, Dr. Kamermans
shall, within 10 days, obtain an Undertaking in
the same form from a person who is acceptable
to the College, failing which Dr. Kamermans
shall immediately cease practice until this requirement is satisfied;
(iii) ollowing the completion of the preceptorship,
F
Dr. Kamermans shall undergo a comprehensive
practise assessment by an assessor or assessors
appointed by the College;
(iv) r. Kamermans shall abide by any and all
D
recommendations of his preceptor(s), and the
assessor(s), including with respect to any practice improvements and/or ongoing professional
development and/or education;
(v) r. Kamermans shall be solely responsible for
D
all fees, costs and expenses associated with his
compliance with the terms of this Order.
3. r. Kamermans pay costs to the College in the
D
amount of $3,650 within 30 days of the date of this
Order.
At the conclusion of the hearing, Dr. Kamermans waived
his right to an appeal and the Committee administered the
public reprimand.
DR. LEONARD MAKEREWICH
Practice Location: Niagara Falls
Practice Area: Otolaryngology, Sleep Medicine
Hearing Information: Agreed Statement of Facts,
Admission, Joint Submission on Penalty
On December 12, 2012, the Discipline Committee
found that Dr. Makerewich committed an act of professional misconduct, in that he has been found guilty
of an offence that is relevant to his suitability to practise; and in that he has engaged in an act or omission
relevant to the practice of medicine that, having regard
to all the circumstances, would reasonably be regarded
by members as disgraceful, dishonourable or unprofessional.
Dr. Makerewich had admitted to the allegations.
Dr. Makerewich’s practice of billing for a special surgical
consultation (A935A) was inappropriate as Dr. Makerewich did not himself personally spend the 50 minutes
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DIALOGUE • Issue 1, 2014
of time with the patient as required by the Schedule
of Benefits but, instead, delegated part of this time to
a non-physician staff member, who was a PhD and
knowledgeable and experienced in sleep medicine.
On December 17, 2010, Dr. Makerewich was found
guilty of knowingly receiving payment between January
16, 2006 and December 1, 2008 for insured services
that he was not entitled to receive, thereby committing an offence pursuant to s.44 of the Health Insurance
Act. He admitted that he billed OHIP and was paid, in
respect of seven patient visits for two different patients,
which did not meet the requirements in the Schedule
of Benefits because in each instance he did not have a
direct physical encounter with the patient or perform
a physical examination. These patients were seen by
the same non-physician staff member. At that hearing,
Dr. Makerewich advised the Court that, shortly after
the charges to which he pled guilty were laid [in June
2009], he substantially modified his practice and billing
practices to ensure that they conformed with billing
requirements and that he ceased billing service code
A935A for patients jointly seen with his staff member.
In fact, this was not correct, as he continued this practice until May 27, 2010.
Reasons for Penalty
Counsel for the College and counsel for the member
made a joint submission as to an appropriate penalty
and costs order.
The relevant penalty principles considered by the Committee were specific and general deterrence, protection
of the public, rehabilitation of the member, maintaining
the integrity of the profession, and public confidence in
self-regulation.
In this era of fiscal constraint for escalating health-care
costs, the Committee wanted to ensure that the penalty
would convey the message to all College members that
improper billing of the Ontario Health Insurance Plan
will not be tolerated as it is a breach of G'W7B