Dec. 11, 2004. 01:00 AMComfy feet cost taxpayers plenty
Orthotics are shoe inserts, shaped to the foot, that are promoted as a way to prevent or cure foot, leg and back pain.
Insurance claims for shoes and shoe inserts by employees of the Toronto Police Service rose to $2.7 million in 2000. In 2003, after limits on orthotic claims were introduced following an insurance probe into skyrocketing costs, the claims had decreased to $543,000.
An investigation by The Hamilton Spectator has found orthotics has gone from being a minor cost item for some employers to one rivalling prescription drugs or dental care.
The result has been an explosion in benefit plan costs.
"There's a lot of money being misused," said Joel Alleyne, executive director of the Canadian Health Care Anti-Fraud Association, which represents some of Canada's biggest insurers.
"It's an industry that cries for regulations," said Doug Allan, administrator of the Hamilton Police Association, which represents 719 police officers and 359 civilian staffers.
The $2.5 million expense over three years was enough to outfit every Hamilton officer, civilian employee and their dependents — some 4,400 people — with a $500 pair of custom-made orthotics. The bill for 2003 was $1.1 million, more than 10 times the amount charged for orthotics three years earlier.
The police benefits plan had no limits on claims for custom-made orthopedic shoes and "adjustments to stock item footwear," as long as the employee got a doctor's prescription. Families and retirees were also covered. The plan, which is funded by city taxpayers through the police budget, was changed last year and a ceiling was placed on spending.
Orthotics typically cost about $500, but marketers have pumped up sales by flogging them outside plant gates, calling patients back every year for a new pair or throwing in free shoes with every pair purchased.
"The word gets out that this is a good way to make money, and then the game is on," said Alleyne. "It is a benefit that unions and people stand to lose with the abuse that is going on."
Alleyne described practices reported by association members around the country:
* Selling $40 off-the-shelf shoe inserts as $500 custom-made orthotics and charging the bill to insurance.
* Providers dispensing large numbers of orthotics, with just one or two professionals writing the prescriptions, suggesting possible kickbacks or other shady dealings between the prescribers and providers.
* Ordinary shoes being sold as custom-made shoes or orthotics being hidden in the cost of so-called orthopedic shoes.
* Patients being provided with incentives such as free shoes, and in some instances, VCRs.
"We've seen people going after the orthotics because they want the (free) shoes," Alleyne said.