President Rodrigo Duterte has ordered state-owned Philippine Health Insurance Corp (PhilHealth) to take action against those involved in the alleged misuse of funds for bogus dialysis treatments.
Duterte issued the directive following claims by whistleblowers that PhilHealth had been approving questionable claims and releasing payments for treatments that were never done.
Palace spokesman Salvador Panelo said Malacanang viewed the allegations with “deep concern.”
“The president directs the management of the PhilHealth to institute criminal actions against those officials and employees who wittingly or unwittingly allowed such misuse of funds to take place for years,” he said in a statement.
“The president instructs the institution’s acting president to submit a detailed report on these irregularities. We will put a stop to this corruption and we will make sure that the law on universal health care is strictly enforced,” Panelo added.
He noted that PhilHealth had already initiated actions on the matter, including the filing of several administrative complaints, and assured that all those involved would be held liable.
“All persons involved in the alleged fraud will be prosecuted and face accountability. They shall reap the harshest penalty imposed by law,” Panelo said.
Edwin Roberto and Liezl Santos, former employees of the WellMed Dialysis & Laboratory Center Corp (WellMed) in Novaliches, Quezon City, claimed in a news report that PhilHealth had continued paying for the dialysis of dead patients.
“The corporation has filed 28 counts of administrative claims for non-admitted treated patients, misrepresentations by furnishing false or incorrect information, and breach of warranties of accreditations performance against the mentioned dialysis centre,” acting PhilHealth President and CEO Roy Ferrer said at a press briefing.
“Also, we have filed several counts of offences against doctors for possible involvement between November and December 2018,” he added.
WellMed has denied the accusation.
Outgoing Sen. Joseph Victor “JV” Ejercito weighed in yesterday, saying PhilHealth should continue providing dialysis benefits amid the controversy. “As I mentioned it will be unfair for the rest to be deprived of Philhealth’s services. Investigations should continue and appropriate charges should be filed,” said Ejercito, principal sponsor and co-author of the Universal Health Care (UHC) law.
Republic Act 11223, signed into law in February, automatically enrols all Filipino citizens in the National Health Insurance Program and prescribes complementary reforms in the health system.
“During our visits to hospitals in different provinces, my own eyes have seen the deplorable state of our countrymen — in hot and cramped wards, enduring the lack of government support. It is sad that our fellow citizens who, rather than be healed, are worried about being infected with the illness of another patient,” Ejercito said.
Also yesterday, Philhealth was dragged into another money controversy but this time it was another government entity that was accused of wrongdoing. In a report, the Commission on Audit (CoA) said the Lung Center of the Philippines (LCP) had failed to forward P22.6bn to patients covered by PhilHealth.
“Verification of the PhilHealth Medicare Patients Refund account showed that the LCP had total collections amounting to P28.058mn from PhilHealth from CYs (calendar years) 2002 to 2018 based on the General Ledger. However, it was noted that only P5.442mn was refunded to the concerned patient-members, leaving P22.616mn still to be refunded,” the CoA said.
The refunds, the CoA explained, “resulted from either an under-deduction or non-availment of benefits at point-of-service due to various circumstances at the time of hospitalisation.”
The CoA said that “unclaimed refunds should have been returned by the LCP to PhilHealth as required” by relevant regulations.