PACC finds cycle of fraud at PhilHealth, identifies officials involved

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The Presidential Anti-Corruption Commission (PACC) has found a “systemic” flaw in state health insurer PhilHealth that has allowed a cycle of fraud to persist, a commissioner said Saturday as the body concluded the first phase of its investigation into alleged corruption at the agency. 

During a briefing on television on Saturday, PACC Commissioner Greco Belgica said that the body has identified officials involved in corruption at the agency, which has been tagged in false insurance claims and alleged overpricing of COVID-19 tests.

The findings of the partial probe will be presented to President Rodrigo Duterte on Monday, Belgica told the Laging Handa briefing.

“We’ve seen loopholes sa system kaya na-perpetuate ‘yung ganitong klaseng system and we’ve identified officials na sangkot dito, positions na vulnerable (We’ve seen loopholes in the system that’s why this kind of system was perpetuated and we’ve identified officials involved, positions that are vulnerable.),” Belgica said.

He said the report also points to “misdoings” of an official who did not take action on corrupt practices.

“There’s really a systemic flaw sa sistema ng PhilHealth kaya napakahirap, paulit-ulit, paulit-ulit, ‘di matigil ang korapsyon (There’s really a systemic flaw in PhilHealth. That’s why it’s really hard, it happens again and again, corruption won’t stop.),” he said.

Belgica described the racket as “basically insurance fraud,” involving PhilHealth’s IT and legal services that allegedly take advantage of “defects” in the system.

He said there were individuals who could easily access official documents.

“Kaya withdrawal lang ng withdrawal, whether it’s a hospital or a patient na manloloko sa PhilHealth, tapos ang PhilHealth naman parang bulag na di nakikita… Di lang parang, sa dami ng nawala talagang nabulag na sila (So whether it’s a hospital or patient trying to dupe PhilHealth, they just continued to make withdrawals, then PhilHealth seemed to be blind and couldn’t see it… Not just seemingly, with the amount lost, they were already blind.),” he said.

Belgica said the partial recommendations will be up for the President’s review.

The PACC will also further investigate the matter, citing the magnitude of corruption at the agency.

He said the PACC would release the report to the public once the President gives instructions.

Duterte has ordered an investigation into alleged corruption at PhilHealth following the resignation of the agency’s anti-fraud officer, lawyer Thorrsson Montes Keith.

Keith cited “widespread corruption” at the agency, an unfair job promotions process, and his opposition to requiring migrant Filipinos to pay PhilHealth dues to make up for the “spillages”of the agency.

PhilHealth president and CEO Ricardo Morales, meanwhile, said in an interview earlier this week that there was “no evidence of corruption” at his agency and that Keith was “vengeful” due to personal reasons.

He said he would not resign and that he would face a Senate inquiry into the corruption allegations. Sen. Christopher “Bong” Go, meanwhile, said the official still has the President’s trust.

While he did specifically mention “loopholes” the PACC found on PhilHealth, Belgica said the agency has issues with their IT.

“Basically IT ang issue. Malaking issue rito po ‘yung IT nila. And then ‘yung legal services po nila dahil supposedly nakikita ito, nadidiskubre… Kasi hindi naman ito mga bagong issues eh, these are recurring issues na iba-iba lang ang cases na hindi nahuhuli,” Belgica said.

The PACC commissioner claimed PhilHealth has not been correcting “defects” in its systems.

“Kaya withdrawal lang nang withdrawal ‘yung mga … whether it’s a hospital or it is a patient na manloloko sa PhilHealth. Tapos ang PhilHealth naman parang bulag na hindi nakikita. Actually hindi lang parang, pero sa dami ng nawala, talagang nabulag na sila sa mga ganito.”

Belgica said they already identified at least 30 individuals involved in the alleged corruption on their list.

PhilHealth spokesperson Doctor Shirley Domingo said,  “We have not yet received the official report, therefore we cannot comment on it.”/Stacy Ang

 

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