Sildvee v. General Manager of the Ontario Health Plan and Medical Review Committee of the College of Physicians and Surgeons of Ontario, (1984) 4 O.A.C. 139 (DC)

Judge:Henry, Reid and Krever, JJ.
Court:Superior Court of Justice of Ontario
Case Date:February 06, 1984
Jurisdiction:Ontario
Citations:(1984), 4 O.A.C. 139 (DC)
 
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Sildvee v. Manager Ont. Health Plan (1984), 4 O.A.C. 139 (DC)

MLB headnote and full text

Sildvee v. General Manager of the Ontario Health Plan and Medical Review Committee of the College of Physicians and Surgeons of Ontario

Indexed As: Sildvee v. General Manager of the Ontario Health Plan and Medical Review Committee of the College of Physicians and Surgeons of Ontario

Ontario Divisional Court

Henry, Reid and Krever, JJ.

June 12, 1984.

Summary:

A doctor claimed payment for services under the Ontario Health Insurance Plan. Many of the billings were for house calls to geriatric patients. The general manager of the Plan felt that the doctor was overpaid and sought recovery or reimbursement for certain of the doctor's billings. The doctor appealed. The Medical Review Committee disallowed a percentage of the doctor's visits. The doctor appealed.

The Health Services Appeal Board disallowed an ever lower percentage of the doctor's visits. The doctor appealed under s. 30 of the Health Insurance Act.

The Ontario Divisional Court allowed the appeal.

Administrative Law - Topic 6164

Judicial review - Statutory appeal - Grounds for review - Error of law - General - The Ontario Divisional Court held that a decision of the Health Services Appeal Board may be reviewed by the courts under s. 30 of the Health Services Act, where the Board erred in its interpretation of the evidence - See paragraph 9.

Government Programs - Topic 1986

Medicare - Claims by doctors - "Premium" billings - A doctor billed the province under the Ontario Health Insurance Plan for house calls during week nights, Sundays and holidays - The Ontario Divisional Court held that such "premium" billings did not depend on the existence of an emergency - See paragraph 10.

Counsel:

T. Kerzner, Q.C., for the appellant, Dr. Sildvee;

D. Posluns, for the Medical Review Committee;

L. Hunter, for the General Manager of OHIP.

This appeal was heard before Henry, Reid and Krever, JJ., of the Ontario Divisional Court on February 6, 1984. The decision of the Divisional Court was delivered by Henry, J., and released on June 12, 1984.

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