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Monday, October 3, 2022

Corruption in PhilHealth in the midst of a pandemic

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This isn’t the first allegations of corruption against PhilHealth, a few years back “Failon Ngayon” exposed how hospitals peddle unnecessary medical procedures to patients so they can collect more from Philhealth. Today, it seems they have found partners inside the health agency to steal people’s money.

The Philippine Health Insurance Corporation (PhilHealth) is now the subject of massive scrutiny after allegations of corruption recently surfaced following the resignation of one of its officers. The Anti-fraud legal officer Thorrsson Keith stepped down believing there is “widespread corruption.” He also complained about his delayed salaries which started when he “investigated officers in PhilHealth.” 

The Senate, constituted as the committee of the whole, opened on Tuesday, August 4, its investigation into allegations of massive corruption in the Philippine Health Insurance Corp. (PhilHealth). The probe was initiated through a resolution filed by Senate President Vicente Sotto III and Senator Panfilo Lacson as allegations of widespread corruption in PhilHealth gained traction following a controversial meeting of PhilHealth officials and members of President Rodrigo Duterte’s Cabinet.

The probe focused on three major issues within PhilHealth — the implementation of the interim reimbursement mechanism, the information and communication technology equipment worth P734 million flagged by the Commission on Audit, and the alleged manipulation of its financial status.

The former anti-fraud officer Thomas Keith of the Philippine Health Insurance Corporation (PhilHealth), told senators on the Senate probe that executives of the embattled agency may have pocketed around P15 billion through fraudulent schemes.  Keith said he testified in the Senate hearing to expose what he called the “crime of the year” in PhilHealth. He was referring to the implementation of the Interim Reimbursement Mechanism (IRM) and the procurement of “overpriced” information technology equipment.

On the same senate hearing, PhilHealth board member Alejandro Cabading, an accountant, revealed these and other irregularities to the Senate, which convened as the “Committee of the Whole” to investigate allegations of “widespread corruption” in the state health insurer. These were an unspecified number of laptops worth more than P119 million, 43 unspecified “ICT resources” worth P40 million, and 3 unnamed projects for P98 million. Senator Panfilo Lacson described overpriced budget proposals for the PhilHealth-ICT projects as “Too blatant, too brazen.”

During the hearing, PhilHealth board member Alejandro Cabading identified 4 of his colleagues as alleged members of the so-called PhilHealth mafia. Senior Vice President (SVP) for legal sector Rodolfo del Rosario, SVP for Management Services Sector Dennis Mas, SVP for Fund Management Sector Renato Limsiaco, and PhilHealth Board of Directors Corporate Secretary Jonathan Mangaoang. On the other hand, Del Rosario Denied that he is part of the Mafia.

During the second house probe, the Philippine Health Insurance Corporation (PhilHealth) defended its decision to give the lion’s share of the reimbursement for coronavirus treatments to a hospital in Davao City – even if cases there are far fewer than in Metro Manila, the epicenter of the pandemic in the country. 

Minority Leader Bienvenido Abante Jr slammed what he described as Philhealth’s seeming “preference” for the Southern Philippines Medical Center (SPMC) in the distribution of the Interim Reimbursement Mechanism (IRM). PhilHealth senior vice president for health finance and policy sector Israel Francis Pargas then said SPMC got the largest IRM share because it recorded the highest number of historical claims in 2019. IRM shares were computed based on hospitals’ historical claims or the average daily claim from the previous year multiplied by 90, which should approximate the amount the medical facilities would need for 3 months.

As of Tuesday, August 11, Davao region recorded 1,572 confirmed COVID-19 cases, significantly lower than Metro Manila’s 76,870 cases and Calabarzon’s 18,054 cases. As a result, lawmakers have challenged PhilHealth officials to sign bank secrecy waiver since they continue to insist they are not guilty of the corruption allegations being hurled at them during the congressional inquiries.

PhilHealth announced on Thursday, August 13, 2020 the suspension of its cash advance system for hospitals amid the ongoing investigation on alleged irregularities in the agency to review its overall implementation and resolve issues arising from Congressional inquiries. PhilHealth also vowed to find ways to make the IRM more responsive to the needs of healthcare facilities affected by the current pandemic to assure patients of continuous access to needed health services. This is after some senators on Wednesday, August 12, said that PhilHealth’s cash advance system should be suspended until the necessary reforms are put in place.

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