Vancouver doctor banned from billing to MSP for 3 years, ordered to repay nearly $700K

B.C.'s highest court has upheld a decision banning a Vancouver doctor from billing to the province's public health insurance plan for three years and ordering him to pay back at least $682,744.

Dr. Nevio Cimolai, a former medical microbiologist at B.C. Children's Hospital, failed to convince a panel of appeal court justices that they should allow a judicial review of a 2021 order from the Medical Services Commission (MSC), even though his appeal was filed four weeks late.

"The record indicates that Dr. Cimolai was well aware of the 30-day limitation period under the Medicare Protection Act before its expiry. Simply put, he failed to file his appeal on time," B.C. Court of Appeal Justice Patrice Abrioux wrote in a unanimous judgment on Monday.

Because the appeal was late, Abrioux said it wasn't necessary to consider Cimolai's allegation that the order was improperly made.

Cimolai had also argued that a B.C. Supreme Court justice who previously dismissed his appeal was biased because he had represented the MSC "many years ago," according to the decision.

Abrioux wrote that there was "nothing, in my view, that would lead a reasonable and informed person with knowledge of all the relevant circumstances," to believe the lower court judge was biased because of that dated connection.

Cimolai, who is also a professor at the University of British Columbia, told CBC in a phone call that he plans to keep appealing the ban.

He alleged that the entire audit process and the actions of the MSC were "grossly fraudulent," biased and ridden with errors and that he was denied access to the patient records he needed to defend himself. He also alleged that the court decisions in his case are not a truthful representation of the facts.

'Significant errors and improprieties'

The broad strokes of the decision to temporarily ban Cimolai from billing to the Medical Services Plan (MSP) are outlined in a March 31 judgment from B.C. Supreme Court Justice Jennifer Duncan.

It says the investigation began when an audit of Cimolai's 2012 billings conducted by the health ministry's billing integrity program turned up "significant errors and improprieties."

That was followed by a 2017 MSC audit that "identified a significant number of billing errors" between November 2011 and October 2016, the decision says.

It goes on to say that Cimolai requested a hearing on the allegations, and one was scheduled for two weeks in December 2019. When he failed to appear, the hearing was rescheduled to July 2020, then pushed back again to September because of COVID-related delays.

Cimolai did not attend the rescheduled hearing, either.

"The panel entered into the record a letter from Dr. Cimolai that said, in effect, that he never consented to the hearing and would not be participating," Duncan wrote.

In the meantime, Cimolai had made written submissions accusing members of the MSC panel of "bias, conflict of interest and lack of independence," but those were dismissed in a decision on May 31, 2020.

The panel issued its immediate three-year ban from MSP on March 18, 2021, according to Duncan's judgment. Apart from repaying $682,744, he'll also have to pay a surcharge and interest.

MSP records show that Cimolai has not billed to the public system since 2017/2018, when his annual total was $266,967.61. In the six years before that, his annual billing to MSP averaged about $659,832.