Resource persons reveal fraudulent schemes in PhilHealth at DOJ hearing

Two resource persons formerly connected with the Philippine Health Insurance Corporation  have revealed fraudulent schemes by officers and employees of the agency in the first investigative hearing of the Task Force PhilHealth, the Department of Justice said on Saturday.

In Friday's hearing of the TF PhilHealth, the two witnesses requested anonymity, the DOJ said.

They revealed that some PhilHealth officers and employees had committed fraudulent acts both at its main and regional offices, colluding with some doctors, hospitals, and banks which acted as remittance centers, the DOJ added.

According to the DOJ, the schemes include the payment of false or fraudulent claims against the corporation, malversation of premiums, and the exploitation by some unscrupulous personalities of the case rate system and the interim reimbursement mechanism (IRM), among others.

Likewise, the resource persons disclosed abuses and flaws in the corporation’s Legal Department and Information Technology office that allegedly made the proliferation of the schemes possible.

The task force, created by the National Bureau of Investigation (NBI), will also include an audit of PhilHealth finances and a lifestyle check on the state insurer's officials and employees.

According to the DOJ, member-agencies agreed to conduct hearings as a whole even as they continue their respective investigations and audits. 

Likewise, they agreed to harmonize efforts in the lifestyle checks currently underway and to be conducted by the different offices and agencies.

Justice Secretary Menardo Guevarra is convener of the Task Force, which is formed by the Office of the Ombudsman, the Commission on Audit, the Civil Service Commission, the Presidential Anti-Corruption Commission, the Office of the Special Assistant to the President, the Anti-Money Laundering Council, the National Bureau of Investigation and the National Prosecution Service. —LBG, GMA News