Doctor operating safer supply clinics billed OHIP $2.5M last year
A doctor running a network of addiction clinics across Ontario, including an Ottawa location that offers safer opioid supply, is billing public insurance about $2.5 million per year.
Dr. Suman Koka is the sole officer and director of Northwood Recovery, which has locations in North York, Hamilton and Manitoulin Island. It operates under the name Recovery North in Sudbury, Timmins and Sault Ste. Marie.
Northwood Recovery opened its first Ottawa location in Hintonburg last year, but quietly moved it to Chinatown this March.
Neighbours in both Hintonburg and Chinatown have criticized Koka for prescribing opioid medications to fentanyl users. They say his patients are trading the prescription drugs on the street to get harder substances, attracting dealers and crime to the area.
City councillors representing both neighbourhoods have urged Northwood Recovery to change its operations or shut down.
In an interview last month, Koka confirmed that the Ottawa clinic offers safer supply, a harm reduction approach intended to help users replace street drugs like fentanyl with safer prescription narcotics.
Among other treatments, Koka prescribes hydromorphone, which is also known by the trade name Dilaudid. He confirmed that he primarily meets with patients at the Ottawa clinic remotely through telemedicine.
CBC submitted a freedom of information request to the Ontario Ministry of Health seeking records of Koka's total billing to the Ontario Health Insurance Plan (OHIP). It reveals that he billed just over $2.3 million in 2023 and nearly $2.5 million in 2024.
Those totals do not represent Koka's profit or take-home pay, since at least some of the money would be used to cover overhead costs at his clinics, which could include rent, supplies and administrative staff.
But the totals are far in excess of typical billing. The average gross clinical payment for Ontario physicians was $388,557 in 2022-23, according to the Canadian Institute for Health Information. Payments for the top quintile — the top 20 per cent of physicians by billing — were $568,432 on average.
CBC also submitted a request for Koka's billing for telemedicine specifically. He billed $524,302 for virtual care services in 2024, including video and telephone consultations.
The figures were current as of January 22 of this year. The documents include a note that physicians still have a three-month period to submit additional claims for processing.
Koka had previously appeared on a Toronto Star database of highly paid doctors published in 2019. According to the Sudbury Star, which cited the Toronto Star's reporting, Koka billed $1.5 million in 2018-19, putting him in the top one per cent of doctors ranked by OHIP billing.
Koka did not respond to a request this week with detailed questions about his 2023 and 2024 billing. He did not explain how he is able to personally see enough patients to bill millions of dollars per year, or whether he is delegating some of the care.
But in a March interview, CBC asked him whether he was still one of Ontario's highest paid doctors.
"I'm not sure about that, but I'll tell you I'm probably one of the hardest working doctors in Ontario," he said at the time.
Previously cautioned for telemedicine practices
Doug Angus, a professor emeritus at the University of Ottawa's Telford School of Management, said Koka would have to see a very high volume of patients to generate that kind of money.
Angus, who specializes in health economics, said Koka's reliance on virtual care could allow him to cycle through patients quickly.
"That's changed the game completely," he said. "There's a lot of general practitioners who would love to have that kind of situation, but there's no way they can generate that kind of gross income with face-to-face visits."
He said that the ministry has tried to rein in high billers, but it's difficult to monitor. He said they haven't yet addressed the question of how many patients a doctor can effectively see.
Koka's membership page on the College of Physicians and Surgeons website shows he has 15 practice locations, as well as hospital privileges at the Health Sciences North regional hospital in Sudbury. His medical professional corporation has 13 different addresses.
The college cautioned him in 2019, after a patient complained that Koka didn't meet with him at all. Instead, a physician assistant at his office prescribed methadone after a virtual appointment.
The college found no sign that the physician assistant had proper training — and noted that delegating care is only appropriate in the context of an existing doctor-patient relationship, which did not exist in that case.
Somerset Coun. Ariel Troster met with Koka last month, along with area MPP Catherine McKenney. In a post to her website, Troster said she insisted on wraparound supports for patients and better security protocols during the meeting.
She said the clinic has hired a security guard and a nurse and committed to removing people from the program if they divert their medications.
In his March interview with CBC, Koka said Northwood Recovery takes drug diversion very seriously. He said patients found to be trading or selling their medications are discharged from the program.
According to Koka, even suspicion can lead the clinic to put patients under a stricter regime where they must take doses on site.
He said telemedicine has increased the number of people he is able to see, allowing more people to access addiction treatment.
"Whether it's through video conference or whether through in person, the interaction is the same," he said.
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Toronto Star
9 hours ago
- Toronto Star
‘There is something wrong': Patients say they are paying out of pocket for cataract surgeries at private clinics
It all started at the optometrist. Stephen Purdey was at a regular checkup to update his prescription last summer when his optometrist flagged something in his eye. The optometrist thought it was cataracts, but recommended Purdey visit an ophthalmologist to confirm. So Purdey visited a private clinic in Toronto in March for a consultation after months on the wait-list to see a specialist, and that is where he said he started to feel 'vulnerable and susceptible.' 'Because of the combination of wanting to do the best thing for yourself,' said Purdey, who is in his 70s. 'Plus not necessarily understanding everything that the doctors are telling you, you really are as a patient vulnerable to suggestions.' ARTICLE CONTINUES BELOW 'And that's what happened to me.' The ophthalmologist he was referred to, according to Purdey, acknowledged that the patient could get his procedure done for free under OHIP. Cataract surgery is considered a 'medically necessary surgery' by the province, so even if a person opts to go to a private clinic they shouldn't be billed for the basic OHIP-covered procedure. Patients who spoke to the Star said they went in for cataract surgery at private clinics and felt they had to pay between a couple of hundred and thousands of dollars out of pocket, whether to bypass reportedly long wait times or receive better treatment, including upgraded lenses. Their stories come at a time when the provincial government continues to expand the number of privately run surgical and diagnostic centres performing cataract procedures, a move first announced two years ago. They also raise questions about whether there are sufficient guardrails in place to make sure patients don't feel pressured to pay out of pocket for upgrades they may not need. In Purdey's case, he said his ophthalmologist offered him other options, such as laser-based eye measurements, instead of a free ultrasound measurement, and 'better quality' corrective lenses — treatments that would cost money but, to Purdey, sounded appealing. 'Right away you have the impression that lasers are better than ultrasound,' he said of the measurement procedure. 'And they said, 'Yeah, that's true.'' ARTICLE CONTINUES BELOW ARTICLE CONTINUES BELOW Laser-based measurements have been found to be more accurate than an ultrasound, although the American Academy of Ophthalmology notes that there does not appear to be a difference between using a laser or ultrasound during the cataract surgery itself. Purdey was convinced, however, so he agreed to spend $650 on the laser measurements and an astigmatism test and said he'd consider paying another $200 to $1,600 for the so-called better lenses, then went home. 'Out of control' The four patients who spoke to the Star for this story are older adults who were worried that they might forever damage their vision if they didn't get surgery for their cataracts. Some of these same patients also said they didn't think they were given all the information they needed to make a decision about whether to pay for so-called better measurements and lenses. 'It is really out of control,' said Natalie Mehra, executive director of the Ontario Health Coalition (OHC), an advocacy group focused on protecting public health care. 'Essentially it's like there isn't public medicare when it comes to eye surgery in Ontario,' says Natalie Mehra, executive director of the Ontario Health Coalition, an advocacy group focused on protecting public health care. 'It's gone.' Richard Lautens Toronto Star Things have gotten so bad from the perspective of the OHC that the group is filing formal complaints with the provincial and federal governments next week, Mehra said. ARTICLE CONTINUES BELOW ARTICLE CONTINUES BELOW She said some private clinics around the province bill OHIP for medically necessary cataract surgeries, as they are allowed to, but also charge patients 'mandatory' user fees for things like eye measurements or the surgery itself in a practice known as extra-billing — which is illegal under Ontario law and a breach of the Canada Health Act. Extra-billing also includes charging patients for speedier care. Mehra noted that the onus to report extra-billing to the province is on patients, many of whom do not realize that such 'mandatory' user fees aren't allowed. After investigating, if the province finds that extra-billing took place, it is required to report this annually to the federal government. Ottawa, in turn, will then claw back a certain amount of funding for the province's medicare program under the Canada Health Act. And, on top of the extra-billing, private clinics are charging patients add-ons under the guise that they are medically necessary for cataracts, Mehra said. Last year, Mehra said the coalition received more than 200 complaints over alleged extra-billing for cataract surgeries, one of the top two concerns the group heard from Ontarians. The other was about patients being kicked out of hospital before they are ready to be discharged. And Mehra said she believes there are probably thousands more who just don't know that they're being charged for what should be a free procedure. For its part, the provincial Ministry of Health said that 32,000 people had publicly funded cataract surgery at community surgical and diagnostic centres in 2024. 'We will continue to deliver more connected, convenient care in every corner of the province, always ensuring that people are accessing the care they need with their OHIP card, never their credit card,' ministry spokesperson Ema Popovic said in an emailed statement. ARTICLE CONTINUES BELOW ARTICLE CONTINUES BELOW Still, Mehra said the complaints heard by the OHC run counter to the intentions of the province's medicare system — something patients also echoed in interviews with the Star. 'Essentially it's like there isn't public medicare when it comes to eye surgery in Ontario,' Mehra said. 'It's gone.' Hazy advice Up until her death in April from complications following cardiac surgery, something about a procedure Judith Deutsch had on her cataract back in 2022 didn't sit right with her, said husband Jim Deutsch. Judith Deutsch, pictured here in March, didn't 'feel good' about her experience seeking care for her cataracts three years ago up until her death in April, husband Jim said. Family photo Three years earlier, the Toronto couple had decided to go to a private clinic after they were told the wait time for cataract surgery covered by OHIP 'was going to be too long' by a doctor at a separate clinic. They considered the situation to be an 'emergency' — she incurred a concussion and a gash on her face because she couldn't see well — so the couple was willing to pay out of pocket to get care faster. 'It was going to cost a lot of money,' Jim told the Star. 'But she kept falling and just wanted to get it done as quickly as possible.' Jim said he doesn't believe that he and his wife were scammed — they were aware of the private option and had the means to afford it. But he said the couple still didn't 'feel good' about paying to 'jump the queue' for Judith's surgery. ARTICLE CONTINUES BELOW ARTICLE CONTINUES BELOW The OHC's Mehra said that long wait times are commonly mentioned by doctors at private clinics to encourage patients to pay out of pocket for their surgeries. 'They say the wait times in the public hospital are two years, which they are not,' Mehra said. 'Most people are getting it in 90 days, so they lie to patients and convince them to pay.' According to the province's surgery wait-time website at the time of publication, the average wait time between a referral and the first clinician appointment for the lowest priority patients is 100 days. Meanwhile, the average wait time between a clinical decision for a surgery and the operation itself is 103 days. It's not just wait times; doctors also upsell patients with 'medically unnecessary stuff,' Mehra said. She said the OHC has heard from past cataract patients that they were encouraged to buy corrective lenses that address non-cataract issues like astigmatism. Judith was one of these patients, with Jim saying his wife ended up paying more than $5,000 for her surgery, including specialty lenses that she thought were connected to her cataracts and would lead to better outcomes for her vision, but later learned were for other eye conditions. Although the couple willingly paid more to get faster care, they say they weren't aware the specialty lenses weren't necessary. ARTICLE CONTINUES BELOW ARTICLE CONTINUES BELOW Mehra said she has also heard of patients being charged for post-operative medicine — something Paula from Barrie told the Star separately. Paula told the Star she had to pay $230 for eye drops after her 2023 surgery at a private clinic, on top of the $5,000 she paid for special lenses and to get faster care. (She said her ophthalmologist told her the wait would be over a year if she did not pay $2,500.) 'That's not right,' Paula said of the eye drop charges. 'They should be covered.' The Star agreed to use only Paula's first name since she has glaucoma and worries that speaking publicly could interfere with her ability to receive care. While Paula knew going into her surgery that she wanted to get upgraded lenses and extra measurements, she said the ophthalmologist didn't ask her if she wanted the upgraded measurements. 'They should have asked me,' she said. 'If there were two options, they should have given me the option of 1 or 2.' ARTICLE CONTINUES BELOW ARTICLE CONTINUES BELOW Patients blame issues with medicare system Jim Deutsch thinks that his wife's experience seeking care for her cataracts stems from a failure of Canada's medicare program. Business She paid $8,000 for cataract surgery at a private clinic on a doctor's referral. She says no one told her OHIP had a free option The office of Ontario's Patient Ombudsman received some 4,429 complaints in the 2023-24 fiscal year — the most since it opened in 2016. Business She paid $8,000 for cataract surgery at a private clinic on a doctor's referral. She says no one told her OHIP had a free option The office of Ontario's Patient Ombudsman received some 4,429 complaints in the 2023-24 fiscal year — the most since it opened in 2016. 'Medicare ended up being something that was quite different from what (Tommy Douglas) originally imagined,' said Deutsch, a psychiatrist who moved to Canada from the U.S. decades ago to work in the country's public system. 'Along the way we've ended up with this situation of scarcity and profit and allowing there to be private clinics that will offer something more speedily.' Paula, too, believes the current system isn't fair — even if she said she would pay out of pocket again to get her surgery done faster. 'There is something wrong with the whole system,' she said, describing it as 'two-tier medicine.' The OHC pins the blame on the Ford government, specifically the passage of Bill 60: Your Health Act in 2023. ARTICLE CONTINUES BELOW ARTICLE CONTINUES BELOW The legislation allows more private clinics to provide certain publicly funded procedures, including cataract surgery. The provincial government said the Act was intended to reduce long wait times, while critics, including the OHC, said it would draw resources away from public hospitals. 'No one is able to regulate and control the private market for health care,' Mehra said. 'The most sensible thing we can do is bring (cataract surgeries) back into public hospitals.' The Ministry of Health's Popovic stood by Bill 60 in her statement to the Star. 'To be very clear, Ontario has provisions through legislation that prohibit a patient from being charged for an OHIP-covered service, legislation that was strengthened by our government through Bill 60,' she said. Popovic added that anyone who believes they have been charged for an OHIP-covered service can contact the Commitment to the Future of Medicare Act program to ask for a review, and that those who have been found to have been billed will be reimbursed. 'Narrowly missed getting trapped' After coming home from the private eye clinic, Purdey changed his mind; he wasn't going to pay for the laser measurements or other add-ons. 'I was told that the laser measurement stuff was better,' he said, 'but they didn't really tell me how much better it was.' He called up the clinic to ask for the OHIP-funded procedures and in late May he had the first round of publicly funded surgery on one of his eyes. 'I'm quite satisfied,' Purdey said the day after his surgery. 'I feel like I narrowly missed getting trapped into spending a whole lot of money.'


Winnipeg Free Press
a day ago
- Winnipeg Free Press
‘Nature of Things' looks at how parenthood changes men's brains and bodies with ‘Dad Bods'
TORONTO – A new episode of CBC's 'The Nature of Things,' timed to Father's Day, explores some of the ways men's brains and bodies adapt to parenthood. The episode titled 'Dad Bods' takes viewers across Canada and around the world to look at social and scientific elements of fatherhood. The Canadian Press spoke with director Christine McLean about how the doc, available now on CBC Gem, came together. CP: Tell me about the tone of the documentary. McLean: I like to think that it's not just humorous, but it's warm-hearted… I think the most important point that came out of all this science, most of it quite recent, only in the last 20 years or so, is that we as humans, we have these incredible bodies that are so adaptable. And especially our brains. What the science is showing us is that given the opportunity, we all have the potential, whether we're male or female, to be great nurturing parents. Dads become more empathetic than they might have been before they had children, but they also become experts in their own child. The part of the brain that's stimulated is the part that allows us to read social cues. And they really become very intelligent in terms of figuring out why a baby is in distress. CP: Did anything you learned while making the documentary surprise you? McLean: I did not know that a man's testosterone typically goes down after he has a child. It made a certain amount of sense because I think many of us notice that when a person becomes a parent, they become a softer, gentler version of themselves… I had no idea that that was linked to biological changes inside that person. That was the first surprise. All men are impacted by hands-on care of children: grandfathers, uncles, adoptive fathers. If they're holding that child, they have those hormonal changes happening. That was all new to me. I think new to most people was the recent science about the benefits of what they call skin-to-skin care, which is common in Canadian hospitals. I remember noticing a few years ago friends would send me photographs of babies being held by their dads, and the dads would have their shirts off. And I'm thinking, what is happening in the delivery room these days? It puzzled me. Is this a weird new selfie that people are taking? Little did I know that there's all kinds of physical benefits to that. The father's heart rate goes down, his blood pressure goes down, the baby is comforted. But also the baby often will take in the good gut bacteria that can be on the dad's skin and it helps their digestive system. And who knew that? That was only discovered a couple of years ago. And we now know that for babies who are born via caesarean section, they don't get the gut bacteria from the mom that they get with a conventional birth. And yet, if dads practise skin-to-skin care, the latest science shows that their contribution to that baby's gut health is as robust as the mom's would have been had she delivered vaginally. It's extraordinary. CP: The episode made me think about masculinity, and the conversations we're having around what masculinity means. McLean: It wasn't one of my goals to delve into that, but watching it, you can't help but think about these things. I would say that anybody watching this documentary is not going to be left with the feeling that a good father isn't masculine. I think they're going to have the exact opposite feeling. The book that inspired it ('Father Time: A Natural History of Men and Babies' by American primatologist Sarah Blaffer Hrdy) delves into that a little bit more. There is this sense that if we are to give men permission or at least encourage them to be close to their children, that the changes that happen in their body result in a different kind of masculinity. I'm not going to say it's less masculine… I think that there's kind of a new version of a hero that's evolving when it comes to fathering children. And I think today's heroes are the dads who get up in the night, the dads that change the diapers, the dads that worry about whether their children are happy. And I don't think that makes them less a man. I think it makes them a greater human being. And I think that discovering there was so much going on in the male body in a sense takes gender out of the equation. CP: How would you respond to someone who doesn't like the idea of their testosterone level going down? McLean: The fact that testosterone goes down, when that was discovered about 20 years ago, it attracted a lot of attention and led to this burgeoning field of science. And I can only assume that there was some concern about that on the part of men, because it's testosterone that allows men and women to build body mass. It leads to competitiveness, it leads to assertiveness. None of those things are bad. The thought of losing some of that, I can understand where somebody — particularly a young man — might not like thinking about that. But anybody who watches this documentary will see that the rewards for being a hands-on dad are so great. Losing a little testosterone in the process is no big deal when you see the rewards, the bonds that develop with your child. Weekly A weekly look at what's happening in Winnipeg's arts and entertainment scene. We couldn't fit everything into the documentary, but what the data shows is, in addition to fathers living longer and having greater health, they have stronger marriages. They have better relationships with their kids. We were focused on the dads, but if you were to look at the children, there are so many profound benefits to a child to having a hands-on dad, in terms of how well they do in school, how well their mental health is. And I think that a good dad makes for a good family, and good families make for a great community, and there's just these ripples of positive impact from dads being as involved as they are today. This interview was edited for length and clarity. This report by The Canadian Press was first published June 5, 2025.


Vancouver Sun
a day ago
- Vancouver Sun
Pharmacy hands Comox mom opioid instead of ADHD drugs for child, 9
A Comox couple is warning other parents to double check their children's prescriptions after a pharmacy wrongly dispensed opioids for their nine-year-old instead of ADHD medication. Sarah Paquin, mother of three young children, said the medication mixup could have been catastrophic for her son. 'As a parent, you worry enough as it is, and then to have such a close call like that, it really hits home.' Paquin said she went to the Shopper's Drug Mart pharmacy on Guthrie Road in Comox on May 28 to pick up her son's medication — dextroamphetamine, a stimulant used to treat Attention Deficit Hyperactivity Disorder. Start your day with a roundup of B.C.-focused news and opinion. By signing up you consent to receive the above newsletter from Postmedia Network Inc. A welcome email is on its way. If you don't see it, please check your junk folder. The next issue of Sunrise will soon be in your inbox. Please try again Interested in more newsletters? Browse here. She said the employee had difficulty finding her son's medication. The employee asked for the boy's name multiple times, and initially couldn't find his name in the system, Paquin said. Once she dispensed the medication, the employee didn't read over the label or confirm information, as is the usual custom, the mom said. The next morning, Paquin's husband, David Paquin, hesitated before giving his son the medication, noting the pills were a different colour. When he checked the label, he saw the drug was the painkiller hydromorphone, which goes by the name Dilaudid. The patient's name on the hydromorphone label was a woman they didn't know. Hydromorphone is about five to seven times more potent than morphine, according to a Canadian Medical Association Journal study. Sarah Paquin said when her husband told her about the error, her heart sank until she realized their son hadn't been given the medication. 'We were like, Oh my God, that was such a close call,' said Paquin. 'It's terrifying. We were very upset about it.' David Paquin dropped his son off at school and went straight back to the pharmacy and spoke to the pharmacist, whom he described as visibly upset and apologetic. She refunded the money paid for the wrong medication, but still couldn't find the correct prescription. The order had to be refilled. The owner of the pharmacy called the couple Wednesday to reassure them their son's medication wasn't given to anyone else, 'which makes me feel a little bit better because on the flip side, I don't want my son's medication to hurt the wrong person either,' said Paquin. She posted her story on a local Facebook page to warn other parents, where she learned of other complaints about the same pharmacy employee, who has been suspended pending an internal investigation. Paquin has also filed a formal complaint with the College of Pharmacists of B.C. and was told by the college it would take about two weeks to investigate and follow up with the family. Paquin said she regretted not double-checking the label, a mistake she said she won't make again. She's warning other parents to exercise the same diligence. A West Shore couple spoke to the Times Colonist in March 2023 after a Langford pharmacy gave their son an oral suspension of sleep medication that was 14 times the prescribed dose. Paquin said she and her husband are unnerved by the 'what ifs' that replay in their minds. 'We could have given him this, sent him off to school not realizing, and he could have overdosed. He could have ended up in a coma and at the very least, probably would have had his stomach pumped.' In a statement, Loblaw, the parent company for Shopper's Drug Mart, called the mistake a case of 'human error' that shouldn't have happened. The company said controls are in place to minimize the risk of patients being handed the wrong prescription, and those controls will be reviewed by employees. The company said the pharmacy owner has reached out to the parents to apologize for any stress the incident caused and to outline corrective steps it's taking. ceharnett@