Rein in fake drug claims

Cue the erectile dysfunction jokes.

The city of Toronto’s auditor general, Beverly Romeo-Beehler, revealed this week that city workers claimed $1.9-million worth of the sex-enhancing drugs Viagra and Cialis last year alone.

Unfortunately, it’s no joking matter. Her audit raises the troubling question of whether some workers are hijacking the city’s healthcare plan to pay for drugs they aren’t consuming themselves.

That in turn points to lax administrative oversight of a plan worth $250 million over the five-year period from 2011 to 2015. That cannot be allowed to continue if council is to maintain the trust of taxpayers at a time when it will likely be looking for more revenues to fund next year’s budget.

Mayor John Tory is right to call for anyone making fraudulent claims to be fired. He should go further. Police should be brought in to look for evidence of criminal activity, perhaps involving organized selling of prescription opioids such as oxycodone and fentanyl.

What’s clear from the audit is that alarm bells should have been ringing at city hall and at the drug-plan administrator’s offices long before the report was released.

For Cialis pills, for example, 16 claimants were reimbursed for between 395 tablets (a 13-month supply) and a whopping 600 tablets in at least one of the years 2013, 2014 and 2015.

More disturbing are the auditor’s findings on the $2 million-plus per year reimbursed for highly addictive prescription opioids.

She reported that 32 claimants were reimbursed for more than18 months’ supply of fentanyl patches over one year, ranging from 19 months to a worrisome six-year supply.

That led one medical expert to suggest to the Star that some billings point to substance abuse and drug dealing.

Lax oversight of the drug plan not only raises the worrisome legal and medical issues of black-market dealings or addiction, it raises the question of why the city has squandered millions in taxpayer dollars on seemingly fraudulent drug claims at a time when departments such as Toronto Community Housing and the TTC are strapped for cash to provide even the most basic of services.

The city promises to try and recover ineligible payments or overpayments when they are identified. That could add up to about $1 million a year. Indeed, Romeo-Beehler made 18 recommendations for tightening controls that would save the city $900,000 every year, as well as a one-time sum of $180,000 that could be recovered from the drug-plan administrator, Manulife.

That may not be much in a city budget that tops $10 billion. But every bit counts at a time when city departments are struggling to find cuts of 2.6 per cent from their already tight budgets at Tory’s request. Worse, it undermines public confidence in city administration and feeds the perception that there’s a river of wasteful “gravy” flowing through city hall.

There’s little evidence of that. But this is just the kind of thing that opponents of any tax or revenue increase are bound to seize on as the city comes to grips with how to pay for major public projects.

The city’s audit committee is to discuss the report on Friday. It must act urgently if it is to maintain taxpayers’ trust in how their dollars are spent.

Lax city drug plan undermines public trust