Ontario’s Auditor-General says the province isn’t auditing doctors whose billings raise obvious red flags, including 82 doctors who claimed to have worked 24 hours or more in a single day, a diagnostic radiologist who billed for an average of 461 patients a day, and an ophthalmologist who billed $6.7-million in one year, more than twice as much as the next highest biller in the specialty.

The same unnamed ophthalmologist has been investigated three times for allegedly charging patients out-of-pocket fees for services that should be free through the Ontario Health Insurance Plan. The first review found the doctor wrongly charged patients, a second cleared the ophthalmologist, and a third is ongoing.

When the Ontario Ministry of Health does identify inappropriate billings, it often negotiates settlements that allow doctors to repay less than what they overbilled, Ontario Auditor-General Shelley Spence found in her annual report, released Tuesday.

“Not recovering overpayments from physicians represents a waste of taxpayer’s money,” the report said. “Stronger payment recovery mechanisms would enable the Ministry to use taxpayer funds more effectively and efficiently, including the possibility of directing those recovered funds to providing more patient care.”