Provoking PhilHealth peculiarities

Provoking PhilHealth peculiarities

We have high hopes the legislative inquiry begun this month into the anomalies at the Philippine Health Insurance Corp. will reach an authentic finale — with those guilty as complained of finding themselves with all speed in jail and paying the hefty fines as mandated by the law.

We are as well bowled over that, following testimonies of knowledgeable officials, there is a “mafia” in the firm, with one instance suggesting a gangland-type execution to silence a witness who exposed the fund scam involving millions of pesos in health insurance funds.

One report, submitted to the legislature, has indicated overpricing moves from one disease to another, jeeringly called a “favorite disease.” The scheme moved from claims for cataract operations to caesarian delivery to pneumonia, the report said.

We are stupefied by reported anomalies which include dialysis costs charged against patients who did not exist. Then the report claimed a syndicate went off with P144 million in unremitted PhilHealth contributions of 22,000 employees of BPO firm Accenture.

It’s heartening to note that President Rodrigo Duterte himself has vowed to go after the officials of PhilHealth involved in the alleged corruption and anomalies within the state insurance firm, adding he himself would endorse the cases against them.

In a taped public address this week, Duterte said he would dedicate the remaining two years of his term to put corrupt PhilHealth officials to jail. “One of the few things that I can do in the remaining two years of my term. I’ll spend my last two years to work on the cases on people who are involved in the PhilHealth anomalies,” he said.

“I assure you I will be the one to endorse the case to the prosecuting office. I will sign it. If we have (gone) through with the investigation, allow the Secretary of Justice (Menardo Guevarra) to complete his investigation and his signature on the endorsement will be accompanied by my signature,” Duterte said.

In the Senate, the Blue Ribbon committee recommended the immediate removal and the filing of graft and corruption charges against several regional executives of Philhealth, called as “mafia” by committee chair Senator Richard Gordon.

We endorse Gordon’s view the Ombudsman should conduct an investigation as to the possibility of filing plunder charges against the officers responsible in Philhealth. This late, there is — with the participation of many officers, collectively or singly in ravaging Philhealth — an urgent need to determine whether or not plunder could be filed against perpetrators of these crimes.

We note the National Bureau of Investigation has said some P114 million in premium contributions from a professional services company were allegedly diverted to various bank accounts instead of PhilHealth back in 2011.

During the House hearing, Surigao Del Norte Representative Robert Ace Barbers brought up the financial settlement among PhilHealth, Accenture, Citibank, and Metrobank, which came after premium contributions from Accenture were supposedly diverted to a Metrobank branch in Batangas.

Atty. Minerva Retanal of the NBI Anti-Fraud Division, who took up the case, confirmed that PhilHealth indeed did not receive the payments from Accenture, although it appeared in their IT system.

“It appears that the payment of member corporation, in this case Accenture, were diverted and that a possible intrusion in PhilHealth’s IT system was made as cover-up,” she said.

PhilHealth is currently facing separate corruption investigations over the allegedly questionable release of funds through its interim reimbursement mechanism as well as the planned procurement of “grossly overpriced” IT equipment, among others. During a Senate hearing last August 4, a resigned PhilHealth anti-fraud officer also alleged that a mafia-like syndicate has various schemes, including the release of funds through said mechanism.

The Senate is recommending the filing of appropriate charges, including malversation, against PhilHealth chief Ricardo Morales and other high-ranking officials over the alleged irregularities.

Justice Secretary Guevarra, serving as chair of the task force investigating PhilHealth, told Duterte the results of the initial investigation found that the legal department of the corrupt-ridden state corporation was “one of the biggest sources of fraudulent activities.”

Authorities should also look into reports that Health Secretary Francisco Duque III, who has had stints on the board of PhilHealth for nearly two decades, could be the “godfather” of the so-called mafia, whose members allegedly defrauded the state-run corporation of billions of pesos.

Lawyer Thorrsson Montes Keith, who blew the whistle on the supposed massive fraud that cost PhilHealth P15 billion in 2019 alone, said Duque’s influence was evident even in the crafting of the controversial interim reimbursement mechanism, a P30-billion financial package intended for hospitals treating COVID-19 patients.

Replying to questions by Sen. Grace Poe, Keith said the health secretary should have conducted due diligence before releasing cash advances to hospitals as chair of the PhilHealth board, adding “I can consider him the godfather of the [PhilHealth] mafia.”

Asked to explain, he said: “Since he has institutional knowledge about the PhilHealth management, you can easily see his [involvement] in the anomalies. [Duque] also approved the appointments of almost all the members of the mafia.”

Keith has accused PhilHealth President and CEO Ricardo Morales of being the “coddler” or “new leader” of the corruption syndicate, which he claimed was composed of the entire PhilHealth executive committee.

We hope, really, that something will go beyond the investigation and presidential indignation.

Featured photo: Former PhilHealth president and CEO Ricardo Morales

Leave a Reply