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Taylor, Andrew Winston

CPSO#: 64009

MEMBER STATUS
Revoked: Discipline Committee as of 04 Sep 2018
CURRENT OR PAST CPSO REGISTRATION CLASS
None as of 23 Jul 1992

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education: University of Toronto, 1991

Practice Information

Primary Location of Practice
Practice Address Not Available

Professional Corporation Information


Corporation Name: Andrew W. Taylor Medicine Professional Corporation
Certificate of Authorization Status: Inactive: Dec 10 2018

Specialties

Specialty Issued On Type
Ophthalmology Effective:30 Jun 1995 RCPSC Specialist

Postgraduate Training

Please note: This information may not be a complete record of postgraduate training.



University of Toronto, 17 Jun 1991 to 15 Jun 1992
Other - Comprehensive Internship

University of Toronto, 01 Jul 1992 to 30 Jun 1993
Resident 2 - Ophthalmology

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 17 Jun 1991
Transfer of class of registration to: Independent Practice Certificate Effective: 23 Jul 1992
Revoked: Discipline Committee. Effective: 04 Sep 2018

Previous Hearings

Committee: Discipline
Decision Date: 29 Jul 2016
Summary:

On July 29, 2016, the Discipline Committee found that Dr. Andrew Winston Taylor committed an act of professional misconduct in that he has engaged in an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.

Dr. Taylor, an ophthalmologist, operated a laser eye surgery clinic in Niagara Falls which offered at least two types of laser eye surgery – Planoscan and Zyoptix. The Zyoptix procedure was the newer, more intricate procedure and required more resources. The Zyoptix procedure was more expensive than the Planoscan procedure.

Dr. Taylor first performed the Zyoptix procedure at the clinic in the summer of 2002. From the summer of 2002 until May 2003 (the “material time”), over 120 patients were billed for the Zyoptix procedure when in fact they had received the less expensive Planoscan procedure. The clinic issued refund cheques to 133 patients in 2003.

The Committee found that Dr. Taylor billed for medical procedures that were not performed and instructed members of his staff to create, alter, or otherwise manipulate medical records related to such procedures. The Committee found that the overbilling was deliberate and intentional and that Dr. Taylor altered or directed the altering of records to make it look as if patients had received the Zyoptix, rather than the Planoscan, procedure. The Committee found that Dr. Taylor directed others to carry out blank firings of the laser (meaning no patient was present but the laser was operated), on numerous occasions in April and May 2003 to support inappropriate billing.

DR. TAYLOR BILLED FOR MEDICAL PROCEDURES NOT PERFORMED

The Committee found that Dr. Taylor billed for the more expensive Zyoptix procedure when he had actually performed the less expensive Planoscan procedure.

The Committee did not believe Dr. Taylor’s testimony that he told every patient, including the more than 120 patients who were charged for the wrong procedure, that they received a different and cheaper procedure than that initially recommended by the optometrist and paid for. The Committee found it utterly inconceivable that this number of patients would have left the laser clinic without asking for their refund, or follow up sometime afterwards, if Dr. Taylor, or any other member of the clinical team, had so informed them; or, if the optometrist had discussed with them the price difference between the Zyoptix and Planoscan procedures.

In the Committee’s view, an informed patient would have inquired prior to leaving the clinic, or sometime afterwards, about the anticipated refund. The Committee found that these more than 120 patients were not informed about the cost differential between the Zyoptix and Planoscan procedures and the possibility of a refund.

Dr. Taylor’s assertion that the failure to refund was due to a communications gap between clinic staff was not plausible. If the failure to refund was the result of a communications gap between the operating room and the administrative office, there would have been no reason for the patient charts to be contemporaneously altered by cutting and pasting and blank firings.

In April 2003, an office manager learned about rumours of a police investigation into overcharging patients at the clinic. The Committee found Dr. Taylor’s reaction to the rumoured police investigation striking because he did not seek any information from the police about the investigation. He did not attempt to confirm whether there was an investigation. Instead, Dr. Taylor sought the advice of a trusted friend with communications expertise while instructing his staff to conduct a chart and financial review.

The Committee found that the assistance of Dr. Taylor’s trusted friend would not have been needed if Dr. Taylor genuinely believed that the overbilling was a mere administrative error. Dr. Taylor’s friend’s expert advice yielded a letter to patients accompanying the refund that was misleading. The letter stated, “A routine fiscal audit of all our patient records has indicated that, notwithstanding preoperative tests, when the final examination in the operating room occurred, one of the planned processes was deemed to be unessential. Regrettably this change was not reflected in our charge to you.” The Committee found that the refund letter accompanying refunds was a deliberate attempt by Dr. Taylor to deceive patients about the reason for the refund. The Committee was troubled by the evasive and untruthful content of the letter. In no way could the reason for these refunds be described as “a routine fiscal audit of all of our patient records.” Nothing in Dr. Taylor’s testimony indicated anything “routine” about the rumoured police investigation that allegedly brought the matter to Dr. Taylor’s attention. Furthermore, not all of the patient records were audited.

The Committee believed the office manager’s testimony that she had tried unsuccessfully in the past to have Dr. Taylor cease the overbilling despite the fact she was unable to recall details of her attempts. The Committee found that the rumoured police investigation was the reason Dr. Taylor finally heeded the office manager’s advice and stopped overbilling his patients.

Two staff members testified that Dr. Taylor had specifically told them not to refund any 2003 patients during the first round of refunds that were dated April 30, 2003. The Committee found that Dr. Taylor deliberately ordered his employees in April 2003 not to refund patients who had been converted from Zyoptix to Planoscan between January and April 2003. Furthermore, the Committee found that Dr. Taylor directed his two employees to not tell the truth to his corporate partners in 2005 about the lack of refunds for converted patients between January and April 2003.

DR. TAYLOR DIRECTED THE ALTERATION OF RECORDS

The charts of patients, who had agreed to the Zyoptix procedure but were subsequently converted to the Planoscan procedure, were improperly altered to make it appear as if the patients had received the Zyoptix procedure when in fact they had received the less-expensive Planoscan procedure. The Committee found that Dr. Taylor directed his staff to alter patient charts using a cut-and-paste method to make it appear as if the more expensive procedure had been performed.

Dr. Taylor was the only party to derive financial gain from withholding the patient refunds for the difference in cost between the procedures. Conversely, had the chart alterations been instigated by the laser technicians who worked for Dr. Taylor, those technicians would have risked severe repercussions had the deceit been discovered by Dr. Taylor. In addition, the Committee noted that the laser technicians who altered the charts did not derive any personal financial benefit from the overbilling. Indeed, the cutting and pasting only added extra time to their already long surgical day.

Cutting and pasting took place after each busy surgical day whenever Zyoptix-to-Planoscan conversions occurred. The altered medical records were vital to covering up the deliberate overbilling. The vast majority of patients during the material time were from the United States.

These altered records would have been especially necessary for patients whose follow-up was to be co-managed by a different physician who was closer to where the patient lived.

After rumours of a police investigation into overbilling began to circulate at the laser clinic in April 2003, it is not contested that some charts were altered using a second method. The laser was “blank fired” (meaning no patient was present and the laser was operated) on numerous occasions in April and May 2003. The “blank fired” false records included patient information and the original date of surgery. These records conveyed the false impression that the more expensive surgery had been performed instead of the less expensive procedure.

Dr. Taylor did not contest that blank firings occurred. However, Dr. Taylor denied that he participated in the blank firings and/or that he instructed the staff to carry them out. The matters of who gave the instructions to conduct blank firings and who was involved in carrying them out were in dispute. The Committee found that Dr. Taylor directed the blank firings of the laser in April and May 2003 and thus contributed to the alteration of patient charts for the purpose of covering up the over-billing. The Committee found that Dr. Taylor ordered and was aware of the blank firings at the material time.

The Committee found that:
Patients were over-billed for procedures that were not performed.

Over 120 of these patients left the laser clinic after their procedure completely unaware
that they were entitled to a refund.

The charts of these patients were altered at the time of the procedure.

These two activities – chart alteration and over-billing – were integrally linked.

The Committee concluded that both the over-billing and the chart alteration were deliberate, and, when considered together, could not have been the result of a communications gap or an administrative error.

The Committee found that Dr. Taylor’s role was critical. Evidence points to his role in instructing a small number of staff to cut and paste the charts. Dr. Taylor’s testimony that every patient was aware of the difference in costs between the promised Zyoptix and the delivered Planoscan was simply not credible since each of those patients left the clinic without asking for their substantial refund. The Committee also found that the letter accompanying the eventual refunds was not truthful. There was no evidence of any motive for the laser technicians and the clinic manager to allegedly create a scheme of chart alteration and over-billing, when the people involved would have had to risk their employment and potential criminal charges without any tangible financial benefit to themselves.

PENALTY

On January 5, 2017, the Discipline Committee reserved its decision on penalty. On April 24,
2017, the Discipline Committee released its decision on penalty and ordered that:
1. The Registrar revoke Dr. Taylor’s certificate of registration effective immediately;

2. Dr. Taylor appear before the panel to be reprimanded within three months of this Order
becoming final; and

3. Dr. Taylor pay costs to the College in the amount of $54,560 within six months of this Order becoming final.

APPEAL

On August 26, 2016, Dr. Taylor appealed the July 29, 2016 decision on finding of the Discipline Committee and on May 26, 2017, Dr. Taylor appealed the April 24, 2017 decision on penalty and costs of the Discipline Committee to the Divisional Court of the Superior Court of Justice.

Pursuant to s. 25(1) of the Statutory Powers Procedure Act, the appeal operated as a stay of the Committee’s decisions in the matter. Therefore, Dr. Taylor’s certificate of registration remained in effect pending the disposition of the appeal.

On September 4, 2018, the Divisional Court dismissed Dr. Taylor’s appeal in all respects.

Therefore, as of September 4, 2018, the decision of the Discipline Committee is in effect.

On October 1, 2018, Dr. Taylor filed a motion for leave to appeal the decision of the Divisional Court to the Court of Appeal. On January 7, 2019, the Court of Appeal dismissed Dr. Taylor’s motion for leave to appeal with costs fixed at $2,500.00.


Decision: Download Full Decision (PDF)
Appeal: Appeal Dismissed
Appeal Decision Date: September 4, 2018
Hearing Date(s): September 15-18, December 16-17, 2014; November 4 and 5, 2015, November 16 and 17, 2015, December 2 and 8, 2015. Penalty Hearing: January 5, 2017

Concerns

Source: Other
Active Date: March 27, 2020
Expiry Date:
Summary:
FINDINGS OF GUILT

Andrew Taylor was found guilty of the following offence:
1. Obtaining payment for any insured service that he knew or ought to have known he was not entitled to obtain under the Health Insurance Act or the regulations, contrary to Section 43(1) of the Health Insurance Act.
DATE: March 5, 2020
SENTENCE: Fine of $15,000 plus a surcharge of $3,750

 

Source: Compliance and Monitoring Department
Active Date: July 20, 2018
Expiry Date:
Summary:
Caution-in-Person and Specified Continuing Education and Remediation Program

A summary of a decision of the Inquiries, Complaints and Reports Committee (“ICRC”) in which the disposition includes a "caution-in-person" or a Specified Continuing Education and Remediation Program (“SCERP”) is required by the College by-laws to be posted on the register, along with a note if the decision has been appealed. A “caution-in-person” disposition requires the physician to attend at the College and be verbally cautioned by a panel of ICRC. A SCERP is one of the dispositions that the College’s ICRC may make in connection with a matter before it, and this disposition requires the member to complete an education and remediation program specified for the member. A note will also be posted when all the elements of the SCERP have been completed.

Summaries will be removed from the register if the decision is overturned on appeal or review. This posting requirement only applies to decisions arising out of a complaint dated on or after January 1, 2015 or if there was no complaint, the first appointment of investigators dated on or after January 1, 2015.

See PDF for the summary of a decision made against this member in which the disposition includes a Caution-in-Person and a SCERP:
Download Full Document (PDF)

 

Source: Inquiries, Complaints and Reports Committee
Active Date: December 16, 2016
Expiry Date:
Summary:
NOTE: This decision has been appealed to the Health Professions Appeal and Review Board.
 
Caution-in-Person and Specified Continuing Education and Remediation Program

A summary of a decision of the Inquiries, Complaints and Reports Committee (“ICRC”) in which the disposition includes a "caution-in-person" or a Specified Continuing Education and Remediation Program (“SCERP”) is required by the College by-laws to be posted on the register, along with a note if the decision has been appealed. A “caution-in-person” disposition requires the physician to attend at the College and be verbally cautioned by a panel of ICRC. A SCERP is one of the dispositions that the College’s ICRC may make in connection with a matter before it, and this disposition requires the member to complete an education and remediation program specified for the member. A note will also be posted when all the elements of the SCERP have been completed.

Summaries will be removed from the register if the decision is overturned on appeal or review. This posting requirement only applies to decisions arising out of a complaint dated on or after January 1, 2015 or if there was no complaint, the first appointment of investigators dated on or after January 1, 2015.
 
See PDF for the summary of a decision made against this member in which the disposition includes a Caution-in-Person and a SCERP:
Download Full Document (PDF)

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