Defensor wants plunder raps filed vs. PhilHealth execs involved in 'mafia' scheme

Anakalusugan party-list Representative Mike Defensor on Wednesday proposed the filing of plunder charges against officials of the Philippine Health Insurance Corp. (PhilHealth) down to the regional level who are allegedly involved in the "mafia" scheme in the agency whose activities supposedly cost the government billions in losses.

During the continuation of the House joint panel hearing on the alleged anomalies at PhilHealth, Defensor raised suspicion on the sudden increase in the number of claims for various illnesses and medical procedures with PhilHealth, which he claimed is a "scheme" of the so-called mafia in the agency.

"We know on the regional level, meron kayong tinatawag na Benefits Claim Committee. At dahil may case rate setup, ibibigay na lang 'yun sa Finance," he said.

"Pagdating sa Finance, walang tanong-tanong dahil submitted ng region, babayaran agad. At pagdating diyan, lalabas na ang pondo sa mga ospital," he added.

Defensor also questioned why the payment of claims for some hospitals only take a while, while those for government hospitals take too long.

"Dahil ba dito sa scheme ng sinasabing mafia, na kapag may usapan sa isang region o ang regional officer sa isang ospital at may usapan sa taas, mabilis ang nagiging bayaran?" he said.

Defensor was convinced that these activities constitute the crime of plunder, and so charges should be filed against the individuals supposedly involved in the scheme.

"I submit to the members of this committee, this in fact is plunder. 'Yung bilyon-bilyong nawala ay plunder," he said.

"At ang aking rekomendasyon ay kasuhan hanggang sa regional level dahil lalabas diyan sinong ospital ang nakinabang, sinong kakuntsaba, dahil malinaw naman ang records ng COA (Commission on Audit) at madali itong imbestigahan," he added. 

Defensor, in the previous hearing, called on PhilHealth to end its case rate system as it has resulted in billions of pesos of losses from the state insurer's funds.

"We would like to request the PhilHealth board who are here with us... at sa atin pong Pangulo na magkaroon na ng malinaw na polisiya, at maging sa amin dito sa Kongreso sa ilalim ng administrasyon ng Pangulong [Rodrigo] Duterte, ay itigil na ang all case rates policy na nagiging ugat ng korapsyon sa PhilHealth," he said. —KG, GMA News