Resigned anti-fraud officer says PhilHealth execs are a ‘mafia’

An anti-fraud officer who resigned from the Philippine Health Insurance Corporation (PhilHealth) last week alleging "widespread corruption" in the state-run national health insurer has accused its executive committee of operating like a mafia.

According to Maki Pulido’s report on “24 Oras,” lawyer Thorrsson Montes Keith had the chance to sit in on executive committee meetings after being hired by PhilHealth in October 2019.

“Ang dami po nilang ina-approve na maanomalyang mga project, ‘yung distribution ng Interim Reimbursement Mechanism funds. Bakit nila ina-approve ‘yun at walang pumapalag sa kanila?” he said.

Interim reimbursement mechanism (IRM) funds are supposed to provide health care providers with much-needed liquidity to adequately respond to health situations, such as the ongoing COVID-19 pandemic.

Keith flagged a memorandum by PhilHealth president and CEO Ricardo Morales allowing hospitals not to liquidate their IRM funds.

“Kapag gano’n po ‘yun, parang puwede na pong mai-compare ‘yun sa intelligence fund na wala na po siyang resibo resibo,” he explained.

Keith also furnished GMA News with a copy of a June 16, 2020 memorandum by Morales stating that the liquidation could be done at a date yet to be announced instead of in March.

Another memorandum dated July 15 told regional offices that they had options on how to liquidate the funds but it was not made clear what the options were.

In an interview with Super Radyo dzBB, Morales said the funds were indeed being liquidated.

“Nili-liquidate ‘to. Hindi pa natin kasi alam kung saan tatama ito [COVID-19]. Ngayon alam na natin na malakas sa NCR, Cebu ‘yan. Ngayon alam natin ‘yan, but back in March, hindi natin alam ‘yan. We wanted to be sure, so pre-emptive ‘yun,” he said.

Keith also brought up PhilHealth's questioned P2.1-billion IT project. 

“[Ang] IT kakaunti lang nakakaintindi niyan, complex kasi siya kaya 'pag dini-describe nila medyo hindi mo maiintindihan pero titingnan mo, ‘Uy parehas naman 'yung description, binago lang,’” he said.

Morales countered that the PhilHealth board had not yet made a decision on the project.

Keith added that he has gone into hiding out of fears for his safety, and referred to Morales' background. "Tiningnan ko sa Google...parang assassin siya dati," he said.

Morales, like many officials appointed by President Rodrigo Duterte, is a retired military general.

Morales also countered Keith's implication that he could be a threat. “Mabait na ako ngayon. Ang hinihiling ko lang sa kaniya, i-substantiate niya ‘yung accusation niya. ‘Yun lang naman,” he responded.

Keith was among the three PhilHealth officers who resigned last week over alleged corruption within the agency. 

The Senate is set to probe the allegations. 

Similar accusations about a PhilHealth “mafia” had also surfaced last year.  — Julia Mari Ornedo/BM, GMA News