Winnipeg Free Press (Newspaper) - February 15, 2014, Winnipeg, Manitoba
C M Y K PAGE A5
SATURDAY, FEBRUARY 15, 2014 A 5
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A WINNIPEG physician has been disciplined
by the Manitoba College of Physicians
and Surgeons for wrongfully billing
the province for patients he never saw.
Dr. Richard Lloyd Letkeman billed Manitoba
Health for $ 39,055.54 between November 2010 and
April 2011 for house calls that were performed by a
nurse practitioner who worked at the same clinic.
According to a report published on the college's
website, the patient visits were billed to the province
using Letkeman's billing number.
Letkeman pocketed 30 per cent
of the fees paid for the house calls,
while the nurse practitioner, ostensibly
acting under his supervision,
received the rest.
" None of the records of the nurse
practitioner/ patient encounters for
which Dr. Letkeman was responsible
contain any indication of Dr. Letkeman's
involvement in the care or any
indication Dr. Letkeman had reviewed
the record and signed off on the care
provided," the college's investigation
committee said in its report.
Letkeman stopped billing for the
nurse practitioner's visits when he
learned the Health Department was
investigating the invoices, the report said.
He has repaid the province for the nearly
$ 40,000 in inappropriate billings. He's also had to
pay the College of Physicians for the cost of its
investigation - $ 6,974.60.
A spokeswoman for Manitoba Health said in an
email Friday the department has forwarded the
matter to the Winnipeg Police Service.
The department spokeswoman said responsibility
for fee- for- service billings rests solely with
the physician - not with the clinic or any of the
doctor's associates.
Through an intermediary, Letkeman declined a
request for an interview, referring a reporter to
his lawyer.
A spokeswoman for the College of Registered
Nurses of Manitoba, which licenses nurse practitioners,
said she is prevented by law from confirming
or denying whether one of its members is
under investigation by that body.
The college of physicians did not name the
nurse practitioner in its report, nor did it name
the clinic where Letkeman worked. However, a
woman who answered the phone at the Four Rivers
Medical Clinic on Main Street confirmed on
Friday the doctor was employed there at the time.
He now works at another city clinic.
Dr. Bill Pope, registrar with the College of Physicians
and Surgeons, said the public censure is no
small punishment for a physician. It is " serious stuff
for a doctor to have your name in the paper for being
censured by your regulatory authority," he said.
The information is also made known to other
provincial physician licensing bodies,
he added.
The college chastised Letkeman
for billing the province as though he
actually saw the patients himself. It
is also concerned the doctor failed
to maintain proper patient records.
" Those are very serious issues for
us," Pope said.
The college's investigation committee
reported Letkeman had
agreed to supervise the nurse practitioner's
care of patients during
house calls. The NP had the use of
a hand- held camera for visiting patients
that allowed the doctor to see
and hear what was occurring on location
via a clinic computer. The system
was tested in the clinic but it was never used
on any house calls.
In an interview with the head of the college's investigation
committee, Letkeman indicated he was
aware one requirement for billing Manitoba Health
was the physician personally see the patient.
" Dr. Letkeman relied upon assurances from
the clinic owner if the bills in question were challenged,
the clinic owner would succeed in a dispute
with Manitoba Health," the report said.
" Dr. Letkeman's only independent inquiry as to
the propriety of the billing system for the nurse
practitioner's house- call visits was one telephone
call to someone in Manitoba Health to ask if Manitoba
Health had policies governing billing for the
work of a nurse practitioner. When told there were
no such policies, Dr. Letkeman made no further
inquiries of Manitoba Health or anyone else."
larry. kusch@ freepress. mb. ca
By Larry Kusch
Doctor disciplined
after billing for
non- existent calls
Charged province for nurse practitioner's work
' None of the records
of the nurse
practitioner/ patient
encounters for
which Dr. Letkeman
was responsible
contain any indication
of Dr. Letkeman's
involvement
in the care'
A_ 05_ Feb- 15- 14_ FP_ 01. indd A5 2/ 14/ 14 8: 06: 19 PM
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