SENATE PROBE

PACC: PhilHealth's weekly P2B to P3B releases exposed to corruption

Philippine Health Insurance Corporation (PhilHealth) has been releasing billions of pesos in payouts every week that are "exposed to corruption," an official of the Presidential Anti-Corruption Commission (PACC) bared Tuesday.

At the resumption of the Senate hearing, PACC Commissioner Greco Belgica also said PhilHealth President and CEO Ricardo Morales should be fired as he noted the alleged widespread corruption in the agency.

“Kung si General Morales po ay hindi aalisin, hindi po maalis ang problema, dahil mula ulo hanggang paa ang corruption sa PhilHealth,” he said.

IT system

According to Belgica, some P2 billion to P3 billion in weekly PhilHealth releases are exposed to corruption because the agency's information technology (IT) system has no validation mechanism.

“Ang IT system na ginagamit ng PhilHealth has no validation mechanism kaya nama-manipulate ng mga empleyado, ospital… hindi chine-check ng PhilHealth kung totoo ang claims nila,” Belgica said.

“Dalawa hanggang tatlong bilyong piso ang nilalabas ng PhilHealth linggu- linggo, na exposed sa corruption. Dahil rito, namimiligro tayong mawalan ng pondo.” 

Belgica then said PhilHealth’s Regional Office has failed to file 220 fraud cases against a hospital, a move which defied the order of the PhilHealth’s central office.“Iniipit halos lahat ng kaso,” he said.

Belgica lamented that even the state-run Landbank, Development Bank of the Philippines and other private entities offered to provide PhilHealth an external validation mechanism at no cost to the government in the past, but PhilHealth supposedly turned down such offers.

“Hindi nila tinanggap kasi maaapektuhan ang pinagkakakitaan nila,” he said.

PACC probe

Aside from the Senate, PACC is also conducting its own investigation on the matter.

“Mahaba po ang listahan ng iniimbestigahan namin. Wala po kaming palulusutin,” Belgica said, adding they are prepared to file cases against PhilHealth officials before the Office of the Ombudsman if need be.

Morales, who was virtually present during the hearing, said one year is not enough to rid PhilHealth of corruption. At the previous hearing, he said around P10.2 billion could have been lost to fraud in 2019 and the amount could further double by next year should the issue remain unaddressed.

Belgica made the testimony in the Senate a week after PhilHealth’s former anti-fraud  legal officer Thorrsson Montes Keith accused PhilHealth’s senior officials of pocketing P15 billion through several fraudulent schemes, including the Internal Reimbursement Mechanism to hospitals for COVID-19 patients, cash advances and the continuous procurement of IT equipment the agency already has.

Aside from Congress  and PACC, a task group formed by Justice Secretary Menardo Guevarra upon orders from President Rodrigo Duterte is also looking into the alleged irregularities in PhilHealth.

At a televised briefing Monday night, Duterte said he would be tough against PhilHealth officials who would be found stealing funds supposed to be for the people’s health insurance program. —KBK, GMA News