Some hospitals paid P1K to ‘fake patients’ to bloat PhilHealth claims —Zubiri

Senate Majority Leader Juan Miguel Zubiri on Tuesday said some health care institutions (HCIs) have come as far as hiring fake patients to extract more money from PhilHealth.

"They pay people P1,000 to act as patients in order to claim for more serious ailments from the Philhealth," Zubiri said during a Senate hearing.

In addition to these, Zubiri said PhilHealth investigators told him that some provincial primary hospitals were also discovered to allegedly have employed instant patients to cover their fraudulent scheme when they were caught off guard in surprise visits.

"Checking the logbook of patients, and inspecting the rooms kung saan po sila natutulog, kung saan dapat sila nakalagay, wala po silang mahanap na tao o pasyente sa lugar na yun. 'Di po nila mahanap ang mga pasyente na 'yun," Zubiri said.

"When asked, the hospital staff would say that they will call the patients and the patients would arrive and go back to their beds. When asked where they came from, may isa daw na sumagot, 'nagpakain lang sila ng baboy,' and other excuses which are absurd excuses to say the least," he added.

Some HCIs are also practicing upcasing by giving patients losartan for hypertension then claiming the case rate as mild stroke to charge PhilHealth as high as P 25,000 per claim, according to Zubiri.

The PhilHealth officials present in the hearing have yet to comment on the allegations as of posting time.

During the previous Senate hearing, PhilHealth chief Morales said the state insurer could have lost P10.2 billion in 2019 due to fraudulent claims.

Morales said his one year of service is not enough to address the problem of fraud. —LDF, GMA News