36 PhilHealth execs linked to alleged overpayments—PACC

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At least 36 officials of the Philippine Health Insurance Corp. (PhilHealth) were linked by the  Presidential Anti-Corruption Commission (PACC) to overpayments allegedly made to hospitals.

PACC commissioner Greco Belgica declined to identify the officials.

The  names have been forwarded to the Office of the President (OP) as part of its initial report regarding the anti-corruption body’s probe into the alleged anomalies in PhilHealth.

Belgica said their recommendation to the OP include dismissal from the service and filing of charges before the Office of the Ombudsman as well as reforms in the state insurer.

“Ang bulk ng problema diyan sa PhilHealth, ‘yung mga ospital claim nang claim ng receivables nila na sobrang taas na hindi nila bina-validate,” he said in a radio interview.

“Ito namang PhilHealth parang ATM na bayad lang nang bayad. Para tayong siningil sa restaurant pero hindi natin tinignan ‘yung [bill].”

He said the corrupt activities took place in the regions.

“Per region kasi ang transaction diyan sa PhilHealth, doon naman talaga ang yarian sa corruption diyan dahil ang operation nasa regions,” Belgica said.

“Probably people already found out how to take advantage of the situation kaya ‘pag nagpadala ‘yung mga tao, kunwari ospital nagpadala ng fraudulent claims, upcasing, ‘yung sipon ginagawang pneumonia, ‘yung mga ganun po ba, so tumataas ang presyo.”

PhilHealth president Ricardo Morales told a Senate inquiry on Tuesday that the fraudulent claims being paid by the state health insurer would significantly be addressed if its information technology system would be improved.

Morales said a membership database equipped with biometrics would help them weed out claimants who are no longer alive.

Belgica reacted to the claim of resigned anti-fraud officer Thorrsson Montes Keith that he was by ordered by Morales to talk to the PACC official to fix the issue of supposedly overpriced COVID-19 test kits.

“Hindi ho pupuwede ang hilutan sa PACC lalong lalo na sa opisina ko. Anyone [who] attempts that, ipahuhuli ko ho ‘yun derecho right there and then,” Belgica said.

The PACC commissioner said he could not remember meeting Keith personally./Stacy Ang

 

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