51 hospitals facing fraud raps got P1.49B advances — solon

AT least 51 hospitals with fraud cases benefited from the interim refund mechanism (IRM)  the Philippine Health Insurance Corp. (PhilHealth).

This was disclosed by Anakalusugan Rep. Mike Defensor at the continuation of the joint public hearing of the House committee on public accounts and good government and public accountability on the irregularities in PhilHealth.

Presenting documents, Defensor said the total amount of IRM release is P1.49 billion.

The IRM is an emergency cash advance measure of PhilHealth to provide hospitals with an emergency fund to respond to natural disasters, calamities as well as other unexpected events.

Based on the documents, there are 4,664 fraud-related offenses of the 51 healthcare facilities recorded from 2013 to 2020. And these cases include padding of claims, post-dating of claims, misrepresentation by furnishing false or incorrect information, fabrication or possession of fabricated forms and supporting documents.

Defensor, chairman of the House committee on public accounts, questioned the PhilHealth officials over the issuance of IRM to hospitals facing fraud cases.

“Itong 51 hospitals na ito ay may fraud cases na binigyan ng IRM… Bakit hindi ni-resolve ang fraud cases bago nag-release ng IRM?” Defensor asked. 

“Kasi sa mata ng publiko, sa mata namin, kung ganito na may mga fraud cases ang mga ospital at institusyon at bibigyan pa rin ng pondo ng PhilHealth, nakakatakot  the lawmaker added.

Resigned PhilHealth anti-fraud officer Thorsson Montes Keith had disclosed that a so-called “mafia,” composed of the executive committee, stole some P15 billion through fraudulent schemes, including those involving the IRM.

Cavite Rep. Elpidio Barzaga Jr. agreed with Defensor saying hospitals with fraud cases should not benefit from IRM funds.

Barzaga asked PhilHeath who proposed or conceptualized the IRM and why it included dialysis in the program.

The PhilHealth officials denied anomaly in the implementation of the IRM and said the intention is to provide patients with the needed healthcare benefits.

TThe IRM has been suspended due to allegations that the release of funds for the country’s coronavirus response was marred with irregularities.
Bank waiver

In a related story, at least 14 officials of PhilHealth, including its president and CEO Ricardo Morales, have signed bank secrecy waivers allowing the Anti-Money Laundering Council to check their bank deposits and transactions amid their alleged involvement in anomalies.

Defensor identified the officials at the resumption of the hearing as Executive Vice President (EVP) Arnel De Jesus; Senior Vice President (SVP) Dennis Mas SVP Atty. Rodolfo Del Rosario Jr.;  SVP Jovita Aragona; Acting SVP Nerissa Santiago; SVP Renato Limsiaco Jr.; SVP Israel Francis Pargas;  VP Oscar Abadu;  Atty. Jonathan Mangaoang;  VP Shirley Domingo;  Area VP Walter Bacareza;  Area VP Francisco Soria and  Senior Manager Bernadette Lico. 

“Binibigyan nila ng karapatan kung sinuman ang magi-imbestiga na tingnan ang kanilang bank accounts,” Defensor said.

Deputy Speaker Luis Raymund Villafuerte and Surigao del Norte Rep. Robert Ace Barbers had challenged PhilHealth officials to sign the bank secrecy waivers.

Barbers said that higher-ranking officials such as Morales and the senior vice presidents (SVPs) of the agency should also be asked to sign the waiver.