A geriatric hospital in Toronto just fired approximately 150 employees after an investigation into a major benefits fraud scheme. 

The investigation found that as much as $5 million in benefits was falsely claimed by Baycrest Health Sciences staff in a time period spanning more than eight years. 

The scheme involved workers of many different professions throughout the hospital, including registered nurses, cleaning staff and personal support workers. But, no doctors were involved. 

The investigation found two main types of organized fraud: one where the employee would submit invoices for a medical service they never used and the provider would receive a kickback, and one where the employee would accept random products such as purses or shoes and the provider would pocket the difference in price between those items and the prescribed medical device. 

Time to audit all Ontario hospital and college/uni benefit plans. I'd support an increase of civil service audits. Wellness benefit fraud is a huge area of growth.

— BITTERCDN (@JackBlackSwan) July 11, 2019

Baycrest originally hired consultants to investigate a possible partnership with other hospitals in a network of approved providers, and the consultants recognized the signs of fraud from other cases of benefits misuse. 

The involved employees were gathered in meetings on Wednesday and told that the jig was up. Many employees then resigned and the remaining workers who didn't were terminated for violating the hospital’s code of conduct and the trust of its administration.

Baycrest Hospital fires 8% of its employees after uncovering multimillion-dollar benefits fraud scheme; should there be a Provincial review of all hospitals to see if this is widespread? https://t.co/uEMYTFt2zN via @nationalpost

— tom closson (@trclosson) July 11, 2019

One of the employees who was fired shared the official dismissal letter with the National Post. It reads, "you, and/or members of your immediate family, have committed multiple acts constituting fraud and/or theft… You deliberately and intentionally engaged in dishonest and unethical behaviour. For this reason, you have irreparably damaged our trust in you.”

The same employee said participation was encouraged by co-workers.

Another involved employee told the National Post she felt she was being treated unfairly by Baycrest. She said she knew it was fraud, but she felt she deserved it because she was paying more into a health benefits plan than she was actually using.

Knowingly filing a false #insurance claim is #fraud and drains valuable resources. Any rationalization explaining why it was done is purely to ease a guilty conscience #Baycrest https://t.co/9jORyc0Gr9

— Jordan Caplan (@JordanCaplan) July 11, 2019

Because of the scheme, Baycrest has lost up to $5 million, plus the cost of the investigation. 

The situation is comparable to the TTC fraud scheme back in 2018, when more than 200 people were fired for benefits fraud. The TTC lost as much as $5 million in that case. 

The TTC scheme led to criminal charges against 10 people, but no criminal charges have been laid in the Baycrest case. 

The one outstanding issue here is Baycrest appears not to have asked the police to investigate for criminal fraud, at least not yet. This is not just an employer-employee issue. Three quarters of the money allegedly defrauded came from Ontario taxpayers. https://t.co/wkae2Wvmx4

— Lorrie Goldstein (@sunlorrie) July 11, 2019

The employee benefits plan at Baycrest Hospital is 75 per cent funded by the Government of Ontario and 25 percent funded by employee premiums. In other words, the fraud negatively impacts the public as well as the other employees at Baycrest.