PhilHealth corruption involves hospitals, professionals —Morales

Resigned PhilHealth president and CEO Ricardo Morales on Tuesday pointed his fingers at hospitals and other professionals regarding corruption involving the state health insurer's fund, saying investigators are "looking at the wrong way."

"You know where the corruption is happening? They are looking at the wrong way. It is at the hospitals, since it's the hospitals who are receiving the money," Morales said in an ANC interview.

"Almost all cases of fraud are in the hospitals and professionals," he added.

He said the investigation should zero in on the possible collusion between hospitals and PhilHealth officials.

"But that would only be a trickle. Karamihan talaga diyan, sa hospitals," Morales said.

A retired military general, Morales resigned from PhilHealth amid investigations on the alleged irregularities in the agency involving some of its officials. He was replaced by former National Bureau of Investigation director Dante Gierran.

Among the alleged PhilHealth irregularities being looked into are the advance payment to hospitals and healthcare facilities, including those not dealing with COVID-19 patients, under the now-suspended Internal Reimbursement Mechanism (IRM); overpriced IT project and paying withholding tax using PhilHealth’s operating fund, among others.

In the middle of the investigations by Congress and the Justice department, Morales also disclosed that he has cancer and is undergoing chemotherapy.

Morales said that while he was aware of the irregularities, he was not able to go after these corrupt hospitals because internal probe in PhilHealth will tip off those engaged in corruption.

“I could not use internal resources. You have to do this kind of investigation with external sources kasi pag internal, magtatakipan lang ‘yan,” Morales said.

Based on the Commission on Audit records, PhilHealth has only been able to liquidate P1 billion of the P15 billion that of the IRM fund that it released to hospitals amid the COVID-19 pandemic.

Morales, however, defended the release of IRM in March, including to those healthcare facilities like dialysis centers that do not deal with COVID-19 patients, even if its release only became illegal by June 11 or after the copy on PhilHealth circular authorizing IRM release was furnished to the Office of the National Administrative Register of the UP Law Center.

Former PhilHealth Senior Vice Presidential Rodolfo del Rosario, Jr., who has also resigned, has also said that IRM releases prior to June 11 were illegal.

“Iyong declaration ng public health emergency last March 8 was the triggering effect. Hospitals have to prepare their quarantine facilities, by personal protective equipment…if we did not do it, we would have left the hospital defenseless,” Morales said.

“[And] we cannot stop them [dialysis centers] from operating. A patient who undergoes dialysis has to continue getting that treatment whether there is COVID-19 or not,” Morales added.

Likewise, Morales said that the amount of IRM releases for the recipients were not determined on a whim but on historical claims of each hospital or healthcare facility pre-COVID-19.

Morales, however, admitted that he should have done better in establishing PhilHealth’s IT system which is deemed crucial in preventing fraudulent transactions. “I underestimated the time needed to get the IT system up and running. I put a lot of hope in it,” he said.

“But there are members of the [PhilHealth] board who had issues with it because they did not understand it, and they thought they are being hoodwinked,” Morales added.

Morales also brushed aside insinuations that the Senate blue ribbon committee chaired by Senator Richard Gordon did not recommend the filing of charges against him over the PhilHealth fund mess since PhilHealth partnered with the Philippine Red Cross, which Gordon chairs, to ramp up the government’s COVID-19 testing efforts.

“The PRC was identified by the Bayanihan law as a government auxiliary. It had the biggest testing capacity at that time, and we needed them to do the testing,” Morales said.

“It is a contract between us and the Red Cross. There are receipts, they are being liquidated and accounted for. I am very confident that it is on the level [of legality],” he added.  —KBK, GMA News