Ottawa says no way to Keewatin dental deal

Health Canada officials say they won’t honour fee-for service billings submitted by dentists working for Kiguti Dental Services in the Keewatin.


IQALUIT An official with the federal Department of Health and Welfare has told the government of the Northwest Territories that Ottawa will not pay extra dental service costs created by a new contract between the Keewatin Regional Health Board and Kiguti Dental Services.

In a July 17 letter, Dr. Jay Wortman, the Ottawa official in charge of Health and Welfare Canada’s non-insured health benefits program, told the GNWT that Ottawa won’t pay the extra costs of having dentists replace dental therapists in the Keewatin region.

“If it is the intention of the KRHB to pass on additional costs to the NIHB program in the form of fee-for-service claims, we will hold back the current funding for the dental therapist program from the contribution agreement and apply that amount to the NIHB budget to offset those billings,” Wortman said in the letter, which is addressed to Warren St. Germaine, the director of financial and management services for the GNWT’s health department.

“Alternatively, if the KRHB plans to use the current dental therapist funding to provide the service through another modality, we will take measures to ensure that no additional billings are paid through NIHB for these services,” the letter goes on to say.

The letter is contained in a package of documents put together by the Kivalliq Inuit Association to support their call for a public inquiry into recent activities of the Keewatin board.

Double billing?

Pierre Blais, who is acting as the director general of Ottawa’s non-insured health benefits program while Wortman is on holiday, said the funding arrangement for the Keewatin’s new dentists may amount to a form of double billing.

“That would be one suspicion that we would have, although I don’t want to put words in anyone’s mouth,” Blais said.

Blais explained that the cost of hiring four dental therapists in the Keewatin region is part of a fixed budget that’s included in the money that Ottawa transfers to Yellowknife every year for territorial health services.

But he said that transfer agreement doesn’t provide for “fee-for-service” claims by dentists on top of that amount.

“The dental therapist is a salaried employee. Whether he sees one person in a day or 10, it matters not. They get paid the same,” Blais said.

Dentists, on the other hand, get paid through “fee-for service” claims.

Since aboriginal people in Canada are guaranteed free health care, Ottawa must pay for their dental bills. In the NWT, that means every time a dentist sees an aboriginal patient, the dentist submits a bill to the GNWT’s health department, which then passes it to Ottawa for reimbursement.

Blais also pointed out that dentists normally expect much higher salaries than dental therapists. The average salary for a dental therapist is normally about $40,000 a year, while dentists usually expect to be paid up to $250,000 a year.

Blais said the GNWT has yet to respond to Wortman’s letter.

Earlier this year, the Keewatin health board created an uproar in the Keewatin region when they announced a plan to fire four dental therapists who had been working within Keewatin schools.

At the same time, they said a new deal with a private company called Kiguti Dental Services would create better dental services provided for Keewatin residents more efficiently.

But Ottawa health officials appear to see the Kiguti deal as a step backwards.

“The unilateral action taken by the KRHB is in direct conflict with our need to maintain the current quality and level of service in the NWT while maintaining an effective community based service,” Wortman said.

Wortman’s July 17 letter was sent only 16 days after Kiguti began to offer dental services under its new arrangement with the Keewatin board.

Earlier this year, hamlet councils in Rankin Inlet, Baker Lake and Arviat, the Keewatin Inuit Association, the Keewatin Divisional Board of Education, and Kivallivik MLA Kevin O’Brien all protested the KRHB’s deal with Kiguti.

Forty-nine per cent of Kiguti Dental Services is owned by Rankin Inlet’s Tapiriit development corporation, while the remaining 51 per cent is owned by dentists Hassan Adam and Charles Pastori.

More recently, numerous groups and individuals have called for a public inquiry into the Keewatin health board’s recent activities.

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