Suspected fraud identified – Brampton medical clinic

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Background 

In August 2011, we alerted you to fraud allegations involving eight health care facility service providers located in Brampton, Mississauga and Toronto, Ontario. You were alerted because plan members of some of our plan sponsors were believed to be impacted by this behaviour.

Sun Life’s Investigative Services Unit has informed us that a ninth health care facility service provider – the Lisa Street Doctor’s Office located in Brampton – allegedly may be committing fraud, with this behaviour believed to be impacting some plan members.

Action being taken 

Our Investigative Services Unit is working together with law enforcement on this investigation and directly with those plan members who have been identified as potentially impacted.

As a result of this suspected fraud and the ongoing investigation, Sun Life will not reimburse plan members for any services or treatment that they receive on or after June 7, 2012, that are provided by the Lisa Street Doctor’s Office.

In addition, as of August 8, 2011, we continue to deny claims for any services or treatment that are provided by any of the following eight health care facilities:

  • Sarwarmed Medical and Health Clinic (Brampton)
  • Conestoga Foot Clinic Inc. (Brampton)
  • Dynamic Footcare & Therapy Inc./Happy Feet are Healthy Feet! (Brampton)
  • Malton Foot and Ortho Clinic (Mississauga)
  • Gore Health Centre (Brampton)
  • Dynamic Optical (Brampton)
  • Woodbine Foot and Orthotics Clinic Inc. (Toronto)
  • Castlemore Optical Inc. (Brampton)

Plan Member communication 

We have provided some suggested messaging for you to distribute to your plan members about this suspected fraud – and about the eight previously identified health care clinics and facilities. Please use this communication as you deem appropriate, but in any event, let your plan members know that Sun Life will not be paying any claims submitted for any services they receive on or after June 7, 2012, from the Lisa Street Doctor’s Office.

Next steps

Sun Life’s Investigative Services Unit continues to investigate this matter – and will examine whether other clinics/facilities may be involved in suspected fraudulent activity. In the event that other clinics/facilities may be involved, we will let you know of this as soon as information becomes available.

Questions? 

If you have any questions, please contact your Client Service Administrator at 1-877-786-7227.