Divisional Court weighs Dr. Ma's $600,000 clawback as Auditor General criticizes OHIP

Doctor Elaine Ma appeared before the Ontario Divisional Court in Toronto on Tuesday, Dec. 2, 2025, seeking the reversal of a Health Services Appeal and Review Board (HSARB) decision to claw back over $600,000 that Ma billed for mass vaccination clinics at the height of the COVID-19 pandemic. 

It is important to note that a Divisional Court judicial review is a legal process that ensures administrative decisions --- in this case, the HSARB decision to claw back the billed funds --- are fair, reasonable, and lawful. The hearing was presided over by the Honourable Justice M. Varpio, the Honourable Justice W. Matheson, and the Honourable Justice S. O’Brien

After the hearing, Kingstonist spoke with Dr. Ma while she was on the train back to Kingston. The conversation revealed some facts not yet discussed, including the Chief Medical Officer of Health's involvement in encouraging Ma to execute the clinics now under scrutiny.

Unsurprisingly, no decision was handed down, Ma shared. 

“We weren’t expecting one,” she said, “but it sure would have been nice.”

Asked if she felt the judges seemed sensitive to her case, the doctor said, “It was interesting. It’s very hard to read the judges, especially on legal issues involving medical students and the limitations around COVax. I’m not sure where they landed on that.” 

COVaxON is the mandatory, secure, cloud-based electronic system used by the Ontario Ministry of Health to manage and document all aspects of the COVID-19 vaccine program across the province. This includes inventory management, dose administration records, and patient information.

Ma said that she doesn’t think people in general, or indeed the Ontario Health Insurance Plan (OHIP), understand how much of her own time and money went into running these clinics. In total, Ma ran 48 mass vaccination clinics, a fact which has never really been highlighted. 

“OHIP doesn’t seem to realize the amount of time that went into those 48 clinics and all the work before and after each one. I don’t think they grasp the sheer number of hours or the expenses. No one has ever asked me for my expenses, so I’ve never supplied them. There’s an assumption that these clinics were profitable, which couldn’t be further from the truth. Some of them even lost money.” 

Rather, she explained, “It was nine months of work, with huge amounts of preparation and then countless hours entering everything into COVax afterward. The biggest clinics — the ones at the centre of all this — took months of follow-up work… this was essentially a whole second full-time job [for me].”

On the other hand, Ma got the impression that the Divisional Court Judges understood that the COVID-19 pandemic was an 'extenuating circumstance' under the Health Insurance Act, which OHIP still maintains it was not. 

“They keep saying it was solely up to Jeff Hutchison, the General Manager of OHIP, to determine that there were ‘extenuating circumstances’ and apply discretion — and he decided there weren’t,” Ma says OHIP told her.

One point Ma learned was that the judges explained that this decision “doesn’t have to be binary — it doesn’t have to be all or none.” However, she was given no sense of when the decision would come.

Auditor General's report on Oversight of Physician Billing

In what might be considered irony, also yesterday, Ontario Auditor General Shelley Spence released her report on the Ministry of Health’s Oversight of Physician Billing, which found that the Ministry uses an outdated claims system.

At the same time that OHIP and the Ministry of Health have been combating Dr. Ma’s billing while never questioning that the work was done, the report concluded that “The Ministry's post-payment audit work has been reactive, relying on tips and complaints instead of data analysis to select physicians for audit. Eight staff are dedicated to this audit work, a number that has not changed since 2017, creating a risk that inappropriate billings remain undetected.”

The report suggests that the Ministry is not using a risk-based data analysis approach for selecting post-payment audits of physicians. Instead, it "relies on tips and complaints." 

“The Ministry does not have effective systems and procedures in place to identify, review and prevent inappropriate physician billings. The Ministry also needs to take more timely, effective and appropriate corrective actions against identified inappropriate billing practices,” according to the audit.

Ontario's Chief Medical Officer of Health

In related news, Ma shared that she recently approached her one-time colleague, Dr. Kieran Moore, Ontario’s Chief Medical Officer of Health. Moore served as the Medical Officer of Health for Kingston, Frontenac, Lennox & Addington (KFL&A) Public Health until 2021, when he was promoted mid-pandemic and widely lauded for his pandemic response in KFL&A.

Ma said that she attempted to speak with Dr. Moore recently when he came to Kingston, but she noted, “It was very clear we couldn’t have the same open conversation as before. And some of what he told me wasn’t even an accurate reflection of what happened [with my vaccination clinics and billing], which was disappointing, especially since he originally came up with this plan and asked me to do it.”

Kingstonist reached out to Dr. Moore and the Ministry of Health for comment. In response, the Ministry stated that Dr. Moore "is not available for this media request" and provided a "statement in lieu."

"During COVID, a Ministerial Order was issued to set up special payments for physicians at designated assessment centres. The order offered an hourly rate for all insured services at assessment centres, including vaccinations. Physicians could also bill existing fee codes for vaccines given in their offices if they did them personally or if they were done by staff," the statement began.

"With the exception of one, who incorrectly billed the Ministry for 21 times their eligible payments, all doctors who hosted vaccination clinics across the province used this special code to bill for vaccination at community clinics," it continued, seemingly singling out Dr. Ma.

"Any physician who failed to follow the Ministerial Order or incorrectly paid staff, needs to return any improperly collected fees to the Ministry."

Kingstonist will continue to provide coverage of this matter and Dr. Ma's case as further information becomes available.