Charge PhilHealth 'mafia' with plunder -- solon

THE chairman of the House committee on public accounts and Anakalusugan Rep. Michael Defensor is proposing the filing of plunder charges against officials of the Philippine Health Insurance Corp. (PhilHealth) who allegedly make up the so-called mafia in the agency.

At the continuation of hybrid hearing of the committees on good government and public accountability and  public accounts, Defensor lamented the billions of pesos lost in PhilHealth due to corruption.

“I submit to the members of this committee, this is in fact plunder. Yung bilyon-bilyong nawala ay plunder,” Defensor said.

“At ang aking rekomendasyon ay kasuhan hanggang sa regional level dahil lalabas diyan anong ospital ang nakinabang, sinong kakuntsaba, dahil malinaw naman ang records ng COA madali itong imbestigahan,” he added.

Also during the hearing three solons, Surigao del Norte Rep. Robert Ace Barbers and Deputy Speakers LRay Villafuerte and Dan Fernandez moved to subject the bank accounts of all PhilHealth officials down to regional directors to scrutiny by the Anti-Money Laundering Council (AMLA).

Defensor pointed out suspicion over the sudden increase in the number of claims for various illnesses and medical procedures with PhilHealth.

"We know on the regional level, meron kayong tinatawag na Benefits Claim Committee. At dahil may case rate setup, ibibigay na lang 'yun sa Finance. Pagdating sa Finance, walang tanong-tanong dahil submitted ng region, babayaran agad. At pagdating diyan, lalabas na ang pondo sa mga ospital," he added.

The House leader also questioned why the payment of claims for some hospitals is faster as compared to other hospitals.

“Yung mga ospital natin particular ang mga government hospitals, ang tagal ng bayaran. Dahil ba dito sa scheme ng mafia na kapag may usapan sa isang region o ang regional officers sa isang ospital at may usapan sa taas, mabilis ang bayaran?” Defensor asked PhilHealth officials.

And this scheme, Defensor  stressed, constitutes the crime of plunder, and so charges should be filed against the individuals supposedly involved in the activities.

Defensor, in the previous hearing, called on PhilHealth to end its case rate system as it has resulted in billions of pesos of losses for the state insurer.

In the same hearing, it was learned PhilHealth losses reached P153.7 billion from 2013 to 2018 due to overpayment and fraud.

At yesterday’s hearing three top officials of PhilHealth, including president and chief executive officer  Ricardo Morales, failed to attend the meeting due to health reasons.

Morales joined the zoom meeting but immediately left because he was not feeling well