Ombudsman orders suspension of 8 PhilHealth execs over P2.7-B IRM

Ombudsman Samuel Martires has ordered the suspension of eight Philippine Insurance Corporation executives over the alleged anomalous release of P2.7 billion worth of PhilHealth funds under the Interim Reimbursement Mechanism policy.

Martires’ suspension order stemmed from the grave misconduct, gross neglect of duty and conduct prejudicial to the best interest of service complaint filed by the National Bureau of Investigation in connection with the release the PhilHealth funds.

Those ordered suspended include PhilHealth Executive Vice President and Chief Operating Officer (COO) Arnel de Jesus, PhilHealth COO for Fund Management Sector Renato Limsiaco, PhilHealth Senior Vice President Dr. Israel Paragas of Health Finance Policy Sector and five others.

The NBI accused these officials of releasing IRM funds on questionable grounds because of the following reasons:

• Presidential Proclamation declaring state of calamity throughout the Philippines due to COVID-19 does not include grant of lRM fund
• IRM disbursement in the form of cash advances does not comply with the Commission on Audit rules on cash advances
• the order for the deferment of the liquidation of funds was issued without providing specific period to do the same;
• a memorandum issued July 2020 giving option to PhilHealth Regional Offices regarding matters of liquidation of the IRM fund

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• the cash advances to the health care institutions were made prior to the effectivity of PhilHealth Circular No. 2020-007 on June 11, 2020 authorizing IRM release and
• PhilHealth officials concerned accorded private entities an unwarranted benefit, advantage or preference through manifest partiality, evident bad faith or gross inexcusable negligence in the grant of the IRM funds by failure to check the track record of applicant in terms of rendering health care services prior to approval of the application
• PhilHealth Board Resolution ratifying the IRM nationwide due to COVID-19 was issued sometime in April 2020 or almost a month after Circular 2020-0007 was released, making its effectivity date to retroact on March 2020 for the Board to legitimize the Memorandum of Agreements and IRM releases on March 23 and 25, 2020  to some favored health care institutions and
• IRM funds which were appropriated specifically to address the adverse effects of COVID-19 diseases,were disbursed to pre-determined health care facilities, some of which are dialysis centers, maternity health care facilities and infirmaries that neither admit nor cater to COVID-19 patients.

Further, the NBI said that the PhilHealth officials facilitated the anomalies by affixing their signatures on official documents causing the release of the questioned IRM funds.

These documents include: Document Review and Assessment Request recommending the approval of fund request of health care institutions, memoranda of agreement with health care institutions, disbursement vouchers, among others.

“After a thorough consideration of the records, this Office finds sufficient cause to place respondents under preventive suspension pursuant to Section 24 of Ombudsman Act,” the Ombudsman said.

The Ombudsman has tasked PhilHealth President Dante Gierran to implement the suspension order. -NB, GMA News