DISCIPLINE COMMITTEE OF THE COLLEGE OF TRADITIONAL CHINESE MEDICINE PRACTITIONERS AND ACUPUNCTURISTS OF ONTARIO

IN THE MATTER OF

the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, and the Traditional Chinese Medicine Act, S.O. 2006, c.27

Decision Date:

April 3, 2020

Indexed as:

Ontario (College of Traditional Chinese Medicine Practitioners & Acupuncturists of Ontario) v David Moon, 2020 ONCTCMPAO 9

Panel:

Richard Dong

Chairperson, Public Member

Deborah Sinnatamby

Public Member

Pixing Zhang

Public Member

BETWEEN:

THE COLLEGE OF TRADITIONAL CHINESE MEDICINE PRACTITIONERS AND ACUPUNCTURISTS OF ONTARIO

-and-

DAVID MOON Reg. No. 2709

Anastasia Hountalas for the College

Member Present, Self-Represented

Edward Marrocco, Independent Legal Counsel

Date of Hearing: January 15, 2020

DECISION AND REASONS FOR DECISION

1This matter came on for hearing before a panel of the Discipline Committee (the “Panel”) on January 15, 2020 at the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario (the “College”).

2David Moon (the “Member”) was present and self-represented.

The Allegations

3On June 20, 2019, the College issued a Notice of Hearing against the Member (the “Notice”), alleging that the Member had engaged in professional misconduct under the Traditional Chinese Medicine Act, 2006 (the “Act”) as follows:

The Member

1. David Moon (the "Member'') became a Grandparented member of the College (R. TCMP, R. Ac) in April 2013. He transferred to the General class (R. TCMP, R. Ac) in October 2013.

2. The Member owns St. Luke Wellness Centre at 1319 Ouellette Avenue in Windsor, Ontario (the "Clinic").

Insurance Fraud

3. On or about June 21, 2017, the College received a complaint from an insurer alleging that the Member engaged in insurance fraud and submitted claims for treatments not actually rendered. Specifically, the insurer reported that:

a. It Identified 185 claims for treatments purportedly provided by the Member, where treatment was not actually rendered by the Member as claimed;

b. It identified an additional 75 claims for treatments purportedly provided by the Member that were unsupported by the Member's records; and/or

c. On or about November 19, 2016 and April 13, 2017, the Member remitted the amount paid to him by the insurer for the treatments identified in paragraphs 3(a)-(b) above to insurer

Record-Keeping

4. Between in or about January 2015 and January 2019, the Member failed to keep records as required. Specifically:

a. The Member failed to maintain treatment notes; and/or

b. The Member failed to maintain accurate billing records.

Acts of Professional Misconduct

5. It is alleged that the above conduct constitutes professional misconduct pursuant to section 51(1)(c) of the Code, being Schedule 2 of the Regulated Health Professions Act (the "Code") as set out in one or more of the following paragraphs of section 1 of Ontario Regulation 318/12 made under the Traditional Chinese Medicine Act, 2006:

a. Paragraph 1: Contravening, by act or omission, a standard of practice of the profession or failing to maintain the standard of practice of the profession (In particular, Standard of Practice (4) - Communication and/or Standard of Practice (5) - Record Keeping);

b. Paragraph 19: Submitting an account or charge for services that the member knows or ought to know is false or misleading;

c. Paragraph 25: Failing to keep records in accordance with the standards of the profession;

d. Paragraph 26: Signing or issuing, in his or her professional capacity, a document that the member knows or ought to know contains a false or misleading statement;

e. Paragraph 48: Engaging in conduct or performing an act relevant to the practice of the profession that, having regard to all the circumstances, would reasonably be regarded by the profession as disgraceful, dishonourable or unprofessional.

Altering and/or Losing Patient Records

6. Between in or about January 2015 and January 2019, the Member lost and/or altered patient records. Specifically:

a.