Whistleblowers reveal PhilHealth fraudulent schemes to inter-agency task force

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Witnesses have revealed fraudulent schemes at the Philippine Health Insurance Corp (PhilHealth) to the inter-agency task force President Rodrigo Duterte directed  to investigate alleged corruption at the state health insurance firm, the panel said on Saturday. 

Task Force PhilHealth, in a statement,  said it has begun its inquiry on the P15-billion alleged questionable cash advances that PhilHealth released to some hospitals – among several investigations on what officials have described as “systemic flaws” at the agency.

Two witnesses/ resource persons who requested anonymity bared schemes allegedly used by PhilHealth officers and employees through the years, both at its main office and regional offices in collusion with some doctors, hospitals, and even banks that served as remittance centers,  during the panel’s initial hearing Friday.

The schemes include alleged payment of false or fraudulent claims, malversation of premiums, and exploitation by some unscrupulous personalities of the case rate system and the interim reimbursement mechanism (IRM), among others, said the task force.

The resource persons also cited flaws in the corporation’s legal department and IT office, which supposedly gave way to these schemes.

The task force, convened by Justice Secretary Menardo Guevarra, met before the hearing “to discuss administrative and logistical matters relating to their work.”

“They agreed to conduct hearings as a whole even as member agencies continue their respective investigations and audits,” according to  the task force.

The panel includes the Office of the Ombudsman, the Commission on Audit, the Civil Service Commission, the Presidential Anti-Corruption Commission, the Office of the Special Assistant to the President, the Anti-Money Laundering Council, the National Bureau of Investigation and the National Prosecution Service.

The panel also agreed that “any action by the agencies regarding PhilHealth will be coordinated through the Task Force and any action towards the prosecution of PhilHealth officers and employees and their cohorts will be made through the Task Force and with the endorsement of the Secretary of Justice.”

President Rodrigo Duterte ordered the creation of the multi-agency task force to investigate officials at the health insurance agency amid allegations of corruption.

PhilHealth is also facing legislative investigations over allegations of systemic corruption after Thorrsson Montes Keith, resigned PhilHealth anti-fraud officer, accused some officials of pocketing around P15 billion in funds through various schemes.

Several other whistleblowers also bared alleged overpricing and overpayment schemes at the agency. /Stacy Ang

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