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PhilHealth 'mafia' stole P15B, says resigned anti-fraud officer

The Philippine Health Insurance Corp. (PhilHealth) "mafia" was able to steal some P15 billion from the state insurer through several fraudulent schemes, a recently resigned official claimed during a congressional hearing Tuesday.

In a Senate hearing, former anti-fraud legal officer Thorrsson Montes Keith said the PhilHealth "mafia" has deep roots in the agency, including top officials in the executive committee.

"Naniniwala po ako base sa aking imbestigasyon na ang perang nawaldas at ninakaw ay humigit kumulang P15 billion," he told Senators.

"Ang aking natuklasan sa PhilHealth ay maitatawag po na krimen ng taon o sa English ay crime of the year."

According to Keith, among the fraudulent schemes being employed are the cash advances, the use of the interim reimbursement mechanism, and the continuous procurement of IT equipment the agency already has.

"Naniniwala po ako na ang dahilan kung bakit hindi natatapos ang korapsyon sa PhilHealth at naging kultura na nga po ito, ay ang pagtatalaga o paglalagay ng mga sindikato o mafia ng kanilang kasamahan, kasabwat, o kapwa sindikato sa mga matataas na posisyon at mga posisyon na nakakatulong sa kanilang iligal na operasyon," said Keith.

The former PhilHealth official also alleged that the "mafia" planned to recover the stolen funds from contributions of the overseas Filipino workers.

In his statement, Keith said he reported such findings to the Presidential Anti-Corruption Commission (PACC), the National Bureau of Investigation (NBI), and the resident Commission on Audit (COA).

He also said he reported his findings to PhilHealth senior vice president Augustus De Villa, who was the one who informed the resigned officer about the supposed mafia.

In the same hearing, Keith alleged that chief executive officer Ricardo Morales tried to use him to iron out the supposed overpriced test kits for the coronavirus disease 2019.

Morales, a retired military general, had earlier dismissed Keith's accusation of widespread corruption in PhilHealth, noting that Keith started making noise after his application for promotion was rejected as he was unqualified for the position.

Morales was also present at the same Senate hearing on Tuesday, but did not respond to Keith's accusations.

However, the PhilHealth chief did not deny fraud in the agency as he even said that based on a study, the corporation could have lost P10.2 billion in 2019 which could even be doubled to P18 billion by next year.

PhilHealth on August 6 denied that its senior officials have pocketed P15 billion through several fraudulent schemes.

The state insurer said the allegations of its former anti-fraud legal officer during the Senate hearing have no basis. KBK/KG, GMA News