Solons threaten plunder raps vs. ex-PhilHealth exec, Manila archdiocese over anomalous settlement

Lawmakers on Tuesday threatened the recommend the filing of plunder charges against a former official of the Philippine Health Insurance Corp. (PhilHealth), the Archdiocese of Manila, and a private company over a settlement case which supposedly caused the loss of P170 million worth of state health insurer's funds.

During the continuation of the House joint panel hearing on the alleged irregularities of PhilHealth, Deputy Speaker Rodante Marcoleta revealed that PhilHealth in 2011 demanded from private company Hospital Managers Inc. (HMI) some P240 million from Cardinal Santos Medical Center (CSMC).

At the time, HMI was managing CSMC, a hospital owned by the Roman Catholic Archdiocese of Manila.

According to Marcoleta, CSMC at that time filed claims with PhilHealth for the full coverage of the medical services for its patients but deducted only P3,000 from their patients' PhilHealth accounts.

The "under-deduction," as Marcoleta described it, resulted in an amount of P240 million from around 48,000 PhilHealth members that availed medical services from CSMC.

The said scheme was confirmed by lawyer Jay Villegas, vice president of the PhilHealth's arbitration office.

"P3,000 ang china-charge ni Cardinal Santos [from] all patients na covered ng PhilHealth. And then Cardinal Santos will claim from PhilHealth the actual fee-per-service payment," Villegas said.

"So ang PhilHealth nagbabayad ng Cardinal Santos ng, let's say, isang case ay P16,000 pero ang binawas lang sa account ng patient ay P3,000," he added.

But Marcoleta said that instead of PhilHealth, it was HMI that filed a case against the state health insurer.

"Bakit imbes na ang PhilHealth ang magdemanda sa HMI, nakakapagtaka naman ang nagdemanda pa sa inyo ay yung HMI, baliktad ang nangyari?" he said.

"Madaling sukatin ito e. The processes taken by PhilHealth is very suggestive of corruption. Imbes na kayo ang magdemanda, hinintay ninyo na kayo ang idemanda ng HMI," he added.

The case eventually ended with the settlement of only P70 million, Marcoleta said, short of P170 million from the original amount.

"Makikita natin, merong demand na malinaw, P240 million. Gumawa sila ng paraan para paikutin ang gobyerno, ang nagdemanda pa yung sinisingil para lang magkaroon ng judicial accounting. Dito nila itinago ito," he said.

House Committee on Public Accounts chair Mike Defensor said this was a clear case of plunder, considering the amount involved is beyond P50 million.

Villegas said that at the time, it was former PhilHealth senior vice president for legal Atty. Edgar Asuncion who decided to have an arbitration and settlement of the demanded amount.

Defensor said the committee has asked Asuncion to attend the previous hearing, but the committee secretariat said they could not locate the former PhilHealth official.

Cavite Representative Jesus Crispin Remulla then suggested that the joint panel asks the help of law enforcement agencies to locate Asuncion.

"We can direct the NBI to study the filing of plunder charges because in this case, the investigation will need law enforcement people to locate Mr. Asuncion, if he does not want to appear before this body. He who does not want to appear before a body like this would seem to be guilty," he said.

Defensor, instead, said that Asuncion should face the joint committee in their next hearing to explain his side.

"If no clarification is given us by Atty. Asuncion by Thursday, this committee will recommend the filing of plunder charges based on the documents submitted to us by PhilHealth arbitration and PhilHealth legal and to file a case against Atty. Edgar Asuncion, the Hospital Managers Inc., and the Roman Catholic Archdiocese of Manila," he said.

Apart from Asuncion, the committee also invited representatives from HMI and the Roman Catholic Archdiocese of Manila shed light on the alleged scheme.