Red Deer pharmacist Michael Tweedy has been suspended from practising for up to one year, starting Feb. 15, for unprofessional conduct and for over-billing Alberta Blue Cross about $1 million.
According to the Alberta College of Pharmacists’ report on a tribunal hearing into Tweedy’s conduct, an Alberta Blue Cross audit of Hilltop Pharmacy, from June 1, 2007, to Jan. 31 2009, was initiated after a tip on the Fraud and Abuse Hotline in February 2008 alleging that drugs were delivered weekly but billed to Alberta Blue Cross daily.
Tweedy told the tribunal that daily billing generated about $45,000 per month in extra revenue and in October 2009, Alberta Blue Cross wanted its $1 million back.
Susan Bramm, senior manager of corporate communications with Alberta Blue Cross, said she was not at liberty to discuss details of the audit except to say “all outstanding issues were dealt with.”
“As a result of a standard compliance review, involving a comprehensive on-site audit of Hilltop Pharmacy in Red Deer, exceptional and significant contraventions were discovered and Alberta Blue Cross initiated actions to recover the amount outstanding,” Bramm said on Wednesday.
“Concerns were also submitted to the Alberta College of Pharmacists as a result of that on-site audit.”
Alberta College of Pharmacists announced Tweedy’s suspension in January.
At the hearing tribunal held about a year ago, the college found that Tweedy, owner of Hilltop Pharmacy since 2002, charged Alberta Blue Cross a daily dispensing fee while actually dispensing and delivering drugs on a weekly basis to residents at Kentwood Place, a transitional housing facility in Red Deer for people with schizophrenia.
Overcharging continued despite concerns expressed by physicians, Alberta Blue Cross and the college.
“This practice resulted in significantly increased revenues coming to Hilltop Pharmacy. Mr. Tweedy engaged in this practice purely to finance the operations of his other business, Kentwood Place,” stated the tribunal report findings, dated July 9, 2011.
Tweedy, landlord and owner of Kentwood Place, charged residents $700 rent per month if they filled their prescriptions at Hilltop Pharmacy, or $1,650 a month if prescriptions were filled elsewhere, according to a witness at the hearing.
Tweedy told the tribunal that daily dispensing was necessary to ensure the safety of Kentwood Place’s 25 clients and that he or another pharmacist was at Kentwood Place every day.
“Even if Mr. Tweedy’s concerns about patient safety were genuine, the Hearing Tribunal does not believe that, in this situation, patient safety with respect to medication security was Mr. Tweedy’s responsibility as a pharmacist. The Tribunal believes appropriate practices were in place at Kentwood Place to deal with patient safety concerns,” the tribunal report findings stated.
Tweedy testified he believed he was responsible for safely securing medications because he had no contract specifying the health region was responsible. He wanted a formal agreement with Alberta Health Services to protect the facility from possible damage or liability caused by residents.
“In these circumstances, a pharmacist should not be libel if a patient overdosed or discontinued their medications. Mr. Tweedy was not the clinic pharmacist at the facility and the evidence has shown that the medications were managed and administered by the staff of Kentwood Place,” the findings stated.
Kentwood Place was staffed by Alberta Health Services, with clinical programming provided in partnership with the Schizophrenia Society of Alberta, according to a tribunal witness.
Tweedy told the tribunal that operating costs for Kentwood Place increased over time more than he expected and daily dispensing did not cover the losses. He couldn’t sell Kentwood Place in 2009 to pay Alberta Blue Cross because the housing project would come to an end. He eventually sold the building in 2010 and paid Alberta Blue Cross out of the proceeds.
Schizophrenia Society of Alberta purchased the facility with a $1.6-million grant from Alberta Seniors and Community Supports and completed $250,000 in renovations by adding to its mortgage.
Tweedy told the tribunal that he did not fill many of the audited prescriptions and the pharmacy’s new computer system was a cause of concern.
The college ordered Tweedy be suspended from practising pharmacy for three years, with the final 24 months of his suspension to be stayed on conditions that he comply with all requirements of the college and respond promptly to any communications from the college.
Sanctions against Tweedy also included three fines of $5,000 each for unprofessional conduct in relation to the dealings with physicians and improper billing for dispensing to residents of Kentwood Place; failure to co-operate or respond to the college’s investigation and conduct displaying acts of ungovernability; and failure to co-operate or respond with the college’s competence committee and the complaint investigator and conduct displaying acts of ungovernability.
Tweedy was ordered to pay 75 per cent of expenses related to the investigation and the hearing to a maximum of $80,000.
Since March 2010, Tweedy has not been permitted to act as a pharmacy licensee. Every pharmacy is licensed in the name of an individual who functions as a pharmacy manager.
On Wednesday, Tweedy told the Advocate he is still one of the owners of Hilltop Pharmacy, but couldn’t comment on the tribunal and sanctions as he was in the process of determining if he should appeal.
There are no restrictions on who can own a pharmacy.
Tweedy has 30 days from his receipt of the written sanctions to file an appeal with the Council of the Alberta College of Pharmacists.