78 hospitals, 18 doctors facing cases over fraud claims —PhilHealth exec

The Philippine Health Insurance Corporation (PhilHealth) on Friday said 78 hospitals are currently facing cases due to fraud claims.

Interviewed on Dobol B sa News TV, PhilHealth senior manager Rey Balena said these hospitals are believed to have been involved 370 fraud cases.

"Ito ho yung nasa arbitration na po. Dito sa non-cataract cases sa kasalukuyan meron pong 78 hospitals na kasalukuyang may kaso involving 370 cases," he said, adding cases have already been filed against 18 doctors.

"For the cataract cases sa ngayon meron tayong tatlong hospitals involving 2,000 cases," Balena said.

"Siguro napakaraming may katarata kaya ginawan nila ito ng scheme," he added.

The government-owned and controlled corporation  which administers the National Health Insurance Program earlier revealed that  it suspended 38 erring officials and employees in the fight against fraudulent and corrupt activities.

It said of those suspended were mid-level managers allegedly involved in processing fraudulent transactions

Two former employees of WellMed Dialysis & Laboratory Center Corp., had claimed that the PhilHealth-accredited facility has been processing and benefiting from claims of deceased patients.

PhilHealth confirmed that they were able to monitor fraudulent acts involving WellMed. Their findings showed that 28 of the medical cases that have been filed involved dead patients while 12 others are under investigation.

"Twenty-eight counts of admin cases na ang naisampa sa prosecution department namin," Balena said. "Meron tayong quasi judicial powers para litisin o dinggin ang ganitong kaso."

WellMed has denied involvement in fraudulent activities. —KBK, GMA News