Published: October 2025
Overview
In Royal College of Dental Surgeons of Ontario v. Kwong, 2025 ONRCDSO 1, the RCDSO Discipline Committee suspended a Scarborough dentist for backdating patient treatment dates to help patients “use up” year-end insurance benefits.
Between December 2020 and January 2021, Dr. Andrew Wai-Ming Kwong and his administrative staff (his wife) submitted insurance claims and ledger entries that falsely showed treatment dates in December 2020, even though the actual clinical work occurred in January 2021.
He admitted to falsifying records, issuing false documents, and submitting false or misleading accounts.
Findings of Professional Misconduct
Dr. Kwong pled guilty to four counts of professional misconduct under Ontario Regulation 853/93, as per RCDSO allegations:
- Falsifying records (para. 26)
- Signing or issuing false reports (para. 28)
- Submitting false or misleading accounts (para. 33)
- Disgraceful, dishonourable, unprofessional, or unethical conduct (para. 59)
He admitted the goal was to allow patients to claim treatment under expiring 2020 benefits.
The Panel rejected any suggestion that this was a harmless “error in judgment,” especially since Dr. Kwong had a prior discipline record (2008) for similar recordkeeping and falsification issues.
Penalty and Terms
The RCDSO Discipline Panel accepted a Joint Submission on Penalty, imposing the following:
- Five-month suspension (starting February 12, 2025)
- Public reprimand
- Mandatory courses within six months:
- Recordkeeping (College-approved)
- Billing practices
- PROBE Program for Professional/Problem-Based Ethics (unconditional pass required)
- 24 months of practice monitoring, focusing on billing and charting, with quarterly/then semi-annual reviews
- Prohibition on employing his spouse in any capacity in his practice
- $10,000 in costs payable within three months
- Mandatory disclosures of suspension to patients, colleagues, and referrers
- Restriction on presence in clinic during suspension except for non-patient emergencies
Key Takeaways
1. “Helping” Patients Can Still Be Misconduct
Backdating or pre submitting insurance claims to preserve benefits is misrepresentation, even if no one “loses money.” Intention to help patients doesn’t excuse altering records.
2. Delegation ≠ Immunity
Administrative staff, even a spouse, act under the dentist’s authority. Regulatory responsibility for billing integrity always rests with the member.
3. History Amplifies Penalty
Repeat themes, false documentation and recordkeeping failures, led to a harsher, deterrent penalty. Prior compliance orders are relevant to future RCDSO discipline outcomes.
4. Structured Remediation Works
Courses, monitoring, and a clear employment ban address the underlying risks while maintaining public confidence in self-regulation.
Practical Lessons for Health Professionals
- Record exact treatment dates as they occur. Ledger and claim dates must match chart notes.
- Review audit logs monthly and reconcile clinical and billing entries.
- Train all staff annually on insurance integrity and no-backdating rules.
- Avoid related-party employment in billing functions or ensure strong oversight.
- On discovering an error, issue a corrected claim and document the explanation trail.
Frequently Asked Questions: RCDSO & Insurance Falsification
Q: Is it okay to backdate a claim if it helps the patient use expiring benefits? A: No. Altering a treatment date to match an insurance deadline is professional misconduct. As seen in RCDSO v. Kwong, “helping” a patient save money by falsifying the date of service is considered submitting false accounts and issuing false documents, regardless of the intention.
Q: Am I responsible if my staff (or spouse) handles the billing? A: Yes. You cannot delegate your professional responsibility for billing integrity. In this case, the fact that the dentist’s wife/office manager processed the false claims did not shield him from a 5-month suspension. The RCDSO holds the dentist accountable for all claims submitted under their name.
Q: Does a “good intention” (helping the patient) reduce the penalty? A: Not necessarily. The Discipline Committee rejected the argument that this was a mere “error in judgment.” Falsifying records strikes at the heart of the profession’s integrity. Even if the dentist gains no direct financial bonus, the act of falsification warrants severe penalties.
Q: What are the consequences of insurance backdating? A: In Kwong, the penalties included a 5-month suspension, a public reprimand, mandatory ethics and recordkeeping courses, 24 months of practice monitoring, and a prohibition on employing his spouse in the practice.
This commentary is for informational purposes only and does not constitute legal advice.
Contact Tamir Litigation Law Firm today at 416-499-1676 or visit tamirlitigation.com to learn how you can protect your licence and your reputation. You can also message us on WhatsApp for a free initial chat.