A South African doctor managed to bill the Canadian government the equivalent of around R22.4 million over four years despite having problems with his medical licence, the Canadian Broadcasting Corporation reports.
Public records show that Sean Cambridge billed an average of C$600,000 (some R5.6 million) per year – even while having trouble with his licence to practice.
That made him a top earner, at more than twice the average income of Canadian family physicians.
Cambridge and his wife, also a doctor, moved to Canada in 2010.
Apparently neither of them passed the necessary exams to practice in Canada but managed to run a very successful practice nonetheless, in an incident that has authorities asking questions.
According to figures their lawyer gave the CBC, the two had a joint 1,180 patients in their last full year of practice.
After initially refusing to release information, medical regulators this week said Cambridge had misrepresented himself in an application for registration and was formally reprimanded.
However, the couple also had admitted trouble with their exams.
In a statement to the CBC they said were proud to have served their patients, but "it undoubtedly came at the expense of studying for our examinations."
"In retrospect, this may not have been the best approach."
South African records show that Cambridge qualified at the University of Limpopo in 2004, and his wife Rosemary at the same university in 2008.
Both are registered as being in foreign practice.