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THE FOLLOWING INFORMATION WAS OBTAINED FROM THE DOCTOR SEARCH SECTION OF THE WEBSITE OF THE COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO WWW.CPSO.ON.CA
Date: 28/03/24 15:43:43 PM

Kumra, Rajiv

CPSO#: 59902

MEMBER STATUS
Expired: Resigned from membership as of 26 Apr 2019
CURRENT OR PAST CPSO REGISTRATION CLASS
None as of 07 Oct 2011

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education: University of Toronto, 1988

Practice Information

Primary Location of Practice
Practice Address Not Available

Professional Corporation Information


Corporation Name: Rajiv Kumra Medicine Professional Corporation
Certificate of Authorization Status: Inactive: Jan 10 2008
Corporation Name: R. Kumra Medicine Professional Corporation
Certificate of Authorization Status: Inactive: Jun 4 2009
Corporation Name: R. Kumra Medicine Professional Corporation
Certificate of Authorization Status: Inactive: May 7 2018
 

Medical Records Location

Instructions/Address:
Medical records requests should be faxed to 416-981-7991
Date Received: 05 Oct 2018

Instructions/Address:
Patients may submit a written request for a copy of their medical record to the above address.
110 - 1885 Glenanna Rd
Pickering, ON  L1V 6R6
Date Received: 14 Feb 2018

Medical Licences in Other Jurisdictions

Effective September 1, 2015, the College by-laws require the College to indicate on the register if the member has a licence or is registered to practise medicine in a jurisdiction outside Ontario, if this is known to the College.



USA - California

Specialties

Specialty Issued On Type
No Speciality Reported

Postgraduate Training

Please note: This information may not be a complete record of postgraduate training.



University of Toronto, 28 May 2001 to 30 Jun 2001
PostGrad Yr 1 - Diagnostic Radiology

University of Toronto, 01 Jul 2001 to 30 Jun 2002
PostGrad Yr 2 - Diagnostic Radiology

University of Toronto, 01 Jul 2002 to 31 Dec 2002
PostGrad Yr 2 - Diagnostic Radiology

University of Toronto, 01 Jan 2003 to 30 Jun 2003
PostGrad Yr 3 - Diagnostic Radiology

University of Toronto, 01 Jul 2003 to 30 Jun 2004
PostGrad Yr 2 - Diagnostic Radiology

University of Toronto, 16 Aug 2004 to 30 Jun 2005
PostGrad Yr 2 - Diagnostic Radiology

University of Toronto, 01 Jul 2005 to 30 Jun 2006
PostGrad Yr 2 - Diagnostic Radiology

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 13 Jun 1988
Transfer of class of registration to: Independent Practice Certificate Effective: 27 Jun 1989
Suspension of registration imposed: Board of Inquiry Effective: 21 Jun 2007
Suspension of registration removed Effective: 19 Feb 2008
Transfer of class of certificate to: Restricted certificate Effective: 27 Oct 2009
Terms and conditions imposed on certificate Effective: 27 Oct 2009
Transfer of class of certificate to: Restricted certificate Effective: 27 Oct 2009
Terms and conditions imposed on certificate Effective: 27 Oct 2009
Suspension of registration removed Effective: 27 Oct 2009
Transfer of class of registration to: Independent Practice Certificate Effective: 27 Oct 2009
Transfer of class of certificate to: Restricted certificate Effective: 10 May 2011
Terms and conditions imposed on certificate Effective: 10 May 2011
Suspension of registration imposed: Discipline Committee Effective: 10 May 2011
Transfer of class of registration to: Independent Practice Certificate Effective: 07 Oct 2011
Suspension of registration removed Effective: 11 Nov 2011
Expired: Resigned from membership. Expiry: 26 Apr 2019

Previous Hearings

Committee: Discipline
Decision Date: 17 Jun 2019
Summary:

On June 17, 2019, the Discipline Committee found that Dr. Kumra committed an act of professional misconduct in that he has engaged in an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, and that he failed to maintain the standard of practice of the profession.

A. Background

Dr. Rajiv Kumra (“Dr. Kumra”) is a 55 year-old family physician who received his certificate of registration authorizing independent practice from the College of Physicians and Surgeons of Ontario (“the College”) on June 27, 1989.

At the relevant time, Dr. Kumra practiced in the greater Toronto area at the following Clinic locations: a) Six Points Clinic; b) Tretheway Clinic; c) Lawrence Avenue Clinic; and d)Pickering Clinic.

B. Disgraceful, Dishonourable or Unprofessional Conduct - OHIP Billing

Between 2012 and 2017, Dr. Kumra engaged in disgraceful, dishonourable or unprofessional conduct by billing the Ontario Health Insurance Plan (“OHIP”) and receiving remuneration for services he did not provide. When a single patient attended Dr. Kumra’s office he directed his staff to register as patients, and bill OHIP, for all the members of the individual’s family or household (i.e. residing at the same address), notwithstanding that Dr. Kumra did not provide treatment to the family and/or household members at that attendance.

The College’s investigation revealed facts including the following:

- On January 14, 2017, Patient A attended Six Points Clinic alone. Her children were not - seen by Dr. Kumra on that date. On that date, Dr. Kumra billed OHIP and was paid for services in respect of Patient A and her three children.
- On August 20, 2016, Patient B attended Six Points Clinic alone. Her children were not seen by Dr. Kumra on that date. On that date, Dr. Kumra billed OHIP and was paid for services in respect of Patient B and her five children. Patients B’s eldest child attended Dr.Kumra’s office on two occasions in August 2016. However, Dr. Kumra billed OHIP and was paid for services in respect of this child on August 14, 20 and 22, 2016.
- On August 27, 2016, Patient C attended Six Points Clinic alone. His children were not seen by Dr. Kumra on that date. On that date, Dr. Kumra billed OHIP and was paid for services in respect of Patient C and his six children.
- On January 14, 2017, Patient D attended Six Points Clinic alone. Her five children were not seen by Dr. Kumra on that date. On that date, Dr. Kumra billed OHIP and was paid for services in respect of Patient D and her five children.
- Patient E attended Six Points Clinic on one or two occasions. Dr. Kumra billed OHIP and was paid for services in respect of Patient E on fifteen occasions between February 28, 2014 and November 1, 2016. On August 20, 2016, Patient E was not seen by Dr. Kumra nor were her six siblings. On that date, Dr. Kumra billed OHIP and was paid for services in respect of Patient E and her six siblings.
- Patient F attended Dr. Kumra’s clinic typically one time per year. None of Patient F’s ten children attended Dr. Kumra’s clinic more than once per year. Dr. Kumra billed OHIP and was paid for services in respect Patient F on 12 occasions between November 24, 2012 and
November 14, 2014. On 11 of those 12 occasions, Dr. Kumra billed OHIP and was paid for services in respect of at least ten other members of his household. Patient F’s daughter accompanied her father on one occasion when he visited Dr. Kumra’s office. She was not seen or assessed by Dr. Kumra at any time. Dr. Kumra billed OHIP and was paid for services in respect of Ms. F on fourteen occasions between February 1, 2012 and August 28, 2015.
- Patient G has not had more than three patient encounters with Dr. Kumra. None of her six children who reside at the same household had more than a single patient encounter with Dr. Kumra. Dr. Kumra billed OHIP and was paid for services in respect of Patient G on nine occasions between June 10, 2012 and April 2, 2014. Dr. Kumra billed OHIP and was paid for services in respect of five of her children on six dates between June 10, 2012 and April 2, 2014.

The College retained Investigative Research Group (“IRG”) to conduct surveillance on Dr.Kumra’s medical practices at the Six Points Clinic and the Tretheway Clinic. The information gathered by IRG was reconciled against Dr. Kumra’s OHIP billing data for the service dates on which surveillance was carried out. The reconciled data shows that Dr. Kumra billed OHIP and was paid for assessment-based services for individuals who did not attend either clinic and who did not receive assessment-based services from Dr. Kumra.

Surveillance conducted on August 20, 2016 at Six Points Clinic and Tretheway Clinic established:

- A total of 84 individuals were observed entering the two practice locations. Only 67 individuals remained in a practice location for more than three minutes. However, on the same date, Dr. Kumra billed OHIP and was paid for assessment-based services in respect
of 97 individuals.
- A total of 19 individuals under the age of 19 were observed entering the two practice locations.However, on the same date, Dr. Kumra billed OHIP and was paid for assessment-based services in respect of 53 individuals 19 years of age or younger.
- A total of 33 males were observed entering the two practice locations. Only 22 remained in a practice location for more than three minutes. However, on the same date, Dr. Kumra billed OHIP and was paid for assessment-based services in respect of 46 males.

Surveillance conducted on September 3, 2016 at Six Points Clinic and Tretheway Clinic established:

- A total of 70 individuals were observed entering the two practice locations. Only 62 remained in a practice location for more than three minutes. However, on the same date, Dr.Kumra billed OHIP and was paid for assessment-based services in respect of 93 individuals.
- A total of 10 individuals under the age of 19 were observed entering the two practice locations. However, on the same date, Dr. Kumra billed OHIP and was paid for assessment-based services in respect of 46 individuals 19 years of age or younger.
- A total of 30 males were observed entering the two practice locations. Only 27 remained in a practice location for more than three minutes. However, on the same date, Dr. Kumra billed OHIP and was paid for assessment-based services in respect of 47 males.

C. Disgraceful, Dishonourable or Unprofessional Conduct - Special Diet Allowance Forms

The Special Diet Allowance (“SDA”) program, administered through Ontario Works, provides additional financial assistance to assist individuals with the costs of a special diet that is required due to an approved medical condition, as confirmed by a healthcare professional,including physicians. Physicians completing SDA forms must satisfy themselves that the patient has the specified condition upon which the special diet allowance is based.

Dr. Kumra engaged in disgraceful, dishonourable or unprofessional conduct by improperly accepting cash from patients in exchange for executing SDA forms and by executing SDA forms without sufficiently assessing the patient, and satisfying himself that the patient has the specified condition upon which the special diet allowance is based.

Between 2010 and 2016, Dr. Kumra improperly charged patients $50 to complete each SDA form in addition to billing OHIP for the same service. In 2016, Dr. Kumra charged patients $100 to complete each SDA form in addition to billing OHIP for the same service.

On two separate occasions between 2013 and 2016, Patient A paid $350 cash for herself and her three children to obtain the completed SDA forms from Dr. Kumra.

In or around September of 2014, because Ontario Works began rejecting SDA forms signed by Dr. Kumra, Dr. Kumra arranged for a physician friend to attend at his clinic once a week to sign SDA forms. Dr. Kumra and his physician friend shared the cash paid by the patients to
obtain the SDA forms. This continued for approximately nine months until May of 2015.Around that time, social services resumed accepting SDA forms signed by Dr. Kumra.

D. Disgraceful, Dishonourable or Unprofessional Conduct - Medical Records

Despite multiple attempts by the College between 2013 and 2017 to obtain Dr. Kumra’s patient records, Dr. Kumra failed to produce and maintain complete patient medical records as required under Part V of Ontario Regulation 114/94, made under the Medicine Act, 1991. According to Dr. Kumra:

- separate servers have been stolen on at least two occasions, including on one occasion by another physician with whom he shared office space;
- his computer has been hacked at least three times; and, separate servers/computers have gone missing on at least three occasions without any explanation (other than one occasion in which Dr. Kumra falsely suggested that the College took it).

Dr. Kumra’s claims were not consistent with evidence obtained by the College.

(i) April 24, 2013 Records Request

On April 24, 2013, College investigators attended at Dr. Kumra’s Six Points Clinic to obtain 26 patient charts. Dr. Kumra produced only 18 of the requested charts.

Dr. Kumra maintained that the 18 charts obtained by the College were incomplete. He claimed that his EMR server was stolen on May 27, 2012 and his replacement computer had been “hacked” on three occasions. He asserted that he was no longer able to access patient records
pre-dating May 28, 2012.

Dr. Kumra’s claims were not consistent with evidence obtained by the College. A staff member working for Dr. Kumra in May 2012 specifically recalled that after the purported theft of the EMR server, patient records reappeared on the computer system. In addition,
subsequent forensic analysis of Dr. Kumra’s server systems retrieved multiple records predating May 28, 2012.

(ii) February 17, 2015 Records Request

On February 17, 2015, College investigators attended at Dr. Kumra’s Six Points Clinic to obtain a variety of information, including electronic medical records. A server was retrieved by the College from the Six Points Clinic at this visit. Dr. Kumra advised College investigators that the complete medical records could be obtained from the Lawrence Avenue Clinic server.

The College investigators attended at the Lawrence Avenue Clinic later on February 17, 2015,and removed two pieces of computer hardware. However, neither was found to contain an active EMR database or patient records, contrary to the information Dr. Kumra had provided
to College investigators.

Prior to College investigators arriving at Lawrence Avenue Clinic, Dr. Kumra took steps to have the EMR server removed from the Lawrence Avenue Clinic.

In an interview with the College on June 22, 2017, Dr. Kumra falsely suggested that during the February 17, 2015 attendance, College investigators removed the “missing” EMR server that purportedly contained the records.

(iii) October 6, 2016 Records Request

On October 6, 2016, College investigators attended at the Six Points Clinic to obtain patient records. Dr. Kumra had prior knowledge that the College would be attending the clinic on this date.

At the site visit, the College investigator provided Dr. Kumra with a letter requesting thirty specific patient records. Dr. Kumra advised the College that the EMR server had been stolen and that he does not have a back-up system for his electronic medical records,despite having been previously advised by his EMR provider to implement a backup solution. The College was unable to obtain any patient records.

(iv) July 7, 2017 Records Request

On July 7, 2017, College investigators and the College’s independent forensic expert attended at Dr. Kumra’s Pickering Clinic to obtain thirty specific patient records. Dr. Kumra was not present but College investigators communicated with Dr. Kumra’s counsel who was apprised of the College’s attendance and activities.

While present at the Pickering Clinic, the College investigators and the independent forensic expert observed from a computer terminal in the Clinic that Dr. Kumra’s EMR application was actively connected to an EMR server. College investigators and the independent forensic expert began to search for the EMR server. While present in the Pickering Clinic, the College investigators and the independent forensic expert then observed from a computer terminal, in real time, that the EMR server had been remotely disconnected and taken offline.

The Pickering Clinic is housed in the same building as Pickering Medical Imaging, a facility owned by Dr. Kumra’s wife. After the server connection was lost, in an attempt to physically locate the server which had suddenly been disconnected, College investigators went outside the building to a utility closet within Pickering Imaging. The College investigators observed the receptionist from Pickering Medical Imaging standing at the utility closet with a cellphone to her ear, carrying a large bag. The College investigators were not given access to observe the contents of the large bag. The receptionist initially denied, but later admitted, that she was speaking with Dr. Kumra on her cellphone. The College investigators were not able to locate the EMR server.

Dr. Kumra directed the receptionist to disconnect the EMR server while the College was in attendance and to remove it from the premises.

Dr. Kumra claimed he was ill and therefore unable to attend at the office on July 7, 2017 when College investigators (and patients) were waiting. He also claimed that he was too ill to return telephone calls. However, a subsequent review of cellphone and internet records indicates that Dr. Kumra was actively using his phone and was mobile during this time period.

(iv) July 8, 2017 Records Request

On July 8, 2017, College investigators attended at the Six Points Clinic and Tretheway Clinic to collect 167 patient records. Dr. Kumra had purportedly treated 26 patients that morning. Dr.Kumra advised College investigators that he created rough notes for these patient encounters but was unable to produce a single note for these 26 patient encounters.

E. Failure to Maintain the Standard of Practice of the Profession

On July 19, 2016, the College retained Dr. Jeff Bloom, Family Physician-in-Chief, University Health Network, to provide an opinion as to whether Dr. Kumra maintained the standard of practice of the profession.

Dr. Bloom was provided with records the College was able to obtain from Dr. Kumra’s practice and related to Dr. Kumra’s patients. These included:

- Patient records obtained in April 2013 from Six Points Clinic;
- EMR records forensically retrieved from Dr. Kumra’s server at Six Points Clinic obtained on February 17, 2015;
- Patient records obtained from other health care providers;
- OHIP billing records; and
- SDA forms obtained from Ontario Works.

 Dr. Bloom delivered his report dated February 16, 2018. Dr. Bloom reviewed the care and treatment provided in 27 cases and opined that Dr. Kumra failed to maintain the standard of practice of the profession and displayed a lack of judgment including with respect to the
completion of SDA forms, his billing practices and his administrative/managerial oversight of his EMR and office practices.

- In many cases, there was no documentation to support the conditions identified on patients’ SDA forms;
- Dr. Kumra completed SDA forms for food allergies and intolerances where contradictory medical records existed;
- In many cases, there was no documented history or physical exam to support the significant number of medical imaging studies ordered by Dr. Kumra;
- In some instances, there were multiple versions of documentation for the same visit and/or templated documentation identical to the documentation in other charts;
- There were submissions for OHIP for which there were no patient records; and/or insufficient documentation to support intermediary assessments billed to OHIP; and,
- Dr. Kumra’s completion of Mandatory Special Necessities Benefit forms were not substantiated by the pattern of care he provided prior and subsequent to completing the form.

Undertaking with the College

On April 26th, 2019, Dr. Kumra signed an undertaking to resign from the College effective immediately and agreed not to apply or re-apply for registration as a physician to practise medicine in Ontario or any other jurisdiction in Canada.

Disposition

On June 17, 2019, the Discipline Committee ordered and directed that:

- Dr. Kumra attend before the panel to be reprimanded.
- Dr. Kumra pay costs to the College in the amount of $6,000.00 within thirty (30) days.


Decision: Download Full Decision (PDF)
Hearing Date(s): June 17, 2019 half day commence at 1:00 p.m. Reprimand: November 18, 2019 at 12:15 p.m.

 

Committee: Discipline
Decision Date: 15 Jul 2009
Summary:

On July 15, 2009, the Discipline Committee found that Dr. Kumra committed an act of professional misconduct, in that he engaged in conduct or an act or acts relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.

Dr. Kumra, with the support of his physician, applied for disability benefits under several insurance policies from 2001 through 2005. As a result, he did receive some benefits. In fact,during various periods of time in which he represented that he was incapacitated, Dr. Kumra had worked as a locum for his physician, had been engaged in a residency program, and had worked as a family physician in California. Dr. Kumra made false representations regarding his capacity to function as a physician and also authorized his physician to do so on his behalf.

On October 27, 2009, the Discipline Committee ordered and directed that:

1. The Registrar suspend Dr. Kumra's certificate of registration for a period of six months, effective immediately.

2. The Registrar impose the following term, condition and limitation on Dr. Kumra's certificate of registration:

(i) Dr. Kumra shall enroll in and complete the College's Medical Ethics and Informed Consent course, at his own expense, at the earliest available date, and in any event, within six months of the date of this Order. This condition is to be removed upon Dr. Kumra providing the College with satisfactory proof of his completion of the course.

3. Dr. Kumra shall appear before the panel to be reprimanded.

4. Dr. Kumra shall pay costs to the College in the amount of $25,550, within 12 months of the date of this Order.

On October 27, 2009, Dr. Kumra appealed the decision of the Discipline Committee to the Superior Court of Justice (Divisional Court). Pursuant to s. 25(1) of the Statutory Powers Procedure Act, the decision of the Discipline Committee was stayed pending the outcome of the appeal.

On May 10, 2011, the Superior Court of Justice (Divisional Court) dismissed the appeal. Therefore, the decision of the Discipline Committee is in effect.
 


Decision: Download Full Decision (PDF)
Appeal: Appeal Dismissed
Appeal Decision Date: 2011-05-10
Hearing Date(s): Jul 15, 2009

Concerns

Source: Member
Active Date: April 26, 2019
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Rajiv Kumra to the College of Physicians and Surgeons of Ontario, effective April 26, 2019:

On June 20, 2018, Dr. Kumra was referred to the Discipline Committee on allegations of professional misconduct and incompetence.

In the face of these allegations, Dr. Kumra resigned from the College and has agreed never to apply or reapply for registration as a physician in Ontario or any other jurisdiction in Canada. Once these allegations have been determined by the Discipline Committee, the decision will be available to the public on the Public Register.

Dr. Kumra was also the subject of open investigations regarding his standard of practice and conduct. In exchange for this undertaking, the College is taking no further action on these investigations.
Download Full Document (PDF)