SENATE majority leader Juan Miguel Zubiri yesterday said the Philippine Health Insurance Corp. paid about P10 million in claims to a 10-bed infirmary “somewhere in Davao” even if it had no patients.
He said the incident, which happened in 2014, is just one of the money-making schemes of a “mafia” at PhilHealth which has been losing billions to corruption. He said the case has been officially investigated but “wala pa rin nangyari (nothing has happened).”
“Biruin mo, nahalungkat namin sa isang lugar sa Davao may isang infirmary diyan, 10-bed capacity lang, 10 kama lang po siya, pero nakakatanggap ng P10M sa PhilHealth, wala naman silang pasyente (We found out that there was a 10-bed infirmary somewhere in Davao which has been getting P10 million from PhilHealth. The hospital only has 10 beds.
It does not have patients),” Zubiri said.
Anomalies at the agency are being investigated by the Senate and House. The Senate has scheduled a hearing for Tuesday. Last Friday, President Duterte ordered the creation of a task force that will also investigate alleged anomalies in PhilHealth.
Zubiri asked Malacañang to suspend all PhilHealth officials who are being investigated either by the Senate or the task force to prevent them from influencing the investigations.
PhilHealth’s rank-and-file workers, meanwhile, urged the President to appoint a caretaker for the state insurer, who is not under investigation, and to temporarily remove Health Secretary Francisco Duque, chair of the PhilHealth board, “being the subject of several investigations.”
PhilHealth president Ricardo Morales has reportedly been advised to take a leave of absence as he will undergo treatment for lymphoma, or cancer of the lymph nodes.
Among alleged anomalies are overpricing of information technology equipment, “ghost” and overpriced PhilHealth claims, and overpriced coronavirus disease (COVID-19) test kits.
Zubiri in an interview with radio dzBB, Zubiri said the P10-million payment to the small infirmary was discovered recently by Senate investigators.
He said he will disclose details of the anomaly during the Senate committee of the whole hearing on Tuesday.
He said the case of this infirmary has been subjected to an investigation of PhilHealth but apparently nothing happened in the probe.
Documents showed the infirmary was actually an 18-bed hospital classified as a tertiary hospital. PhilHealth decided to stop the hospital’s claims due to questionable “striking figures in claims. It was among the top seven highest paid facilities in the Davao region for pneumonia claims “having collected P18M in 2014 and almost P10M in the first semester of 2015.”
Zubiri said the PhilHealth mafia continues to drain the corporation’s funds which are coming from its members’ monthly premium payments. “Dapat buwagin na ang mafia dyan sa PhilHealth. Nako-cover up nila ang corruption. Maraming schemes yan, meron rebate scheme yan, ghost patients scheme yan, overpricing ng IT (information technology),” he said.
‘PRIVACY NOT RESPECTED’
PhilHealth, in a statement, said Morales will attend the hearing although he will have to do so virtually.
“He had every intention to attend the Senate hearing scheduled this August 11 or any investigations,” said PhilHealth.
PhilHealth and Morales rued the public release of his medical certificate, saying it was submitted to the Senate only to support his request to attend hearings virtually.
“He submitted his medical certificate, as required, to request Senate to allow his online instead of his physical presence,” said PhilHealth.
“I regret that my privacy was not respected,” said Morales.
Zubiri said Health Secretary Francisco Duque III is expected to appear before the Senate hearing on Tuesday to shed light on the irregularities in the corporation.
Zubiri and Sen. Christopher Go, chair of the health committee, Marcos called for the suspension of PhilHealth officials under probe.
Zubiri and Go are disappointed over reports that task force probers are having a hard time gathering documents from PhilHealth.
Zubiri said suspension is not an excuse not to attend the Tuesday hearing.
He said it is understandable if Morales and PhilHealth executive vice president Arnel de Jesus will not attend the next hearing for humanitarian consideration.
Last Saturday, Morales’ camp sent a letter to the Senate committee of the whole informing senators that he has been advised by his doctors to take a leave of absence as he is undergoing chemotherapy for lymphoma.
De Jesus also sent a letter to the committee attached with a medical certificate showing he has been confined at a hospital since August 5 due to health problems.
Zubiri said PhilHealth officials under probe who will “fall sick only now” will not be excused from attending the hearing.
Go said officials who will be found guilty in the PhilHealth anomalies must be kicked out of the service and charges filed in court.
The PhilHealth Workers for Hope, Integrity, Transparency and Empowerment (PhilHealth-WHITE), in a statement titled “Enough is Enough,” said Duterte should take advantage of the opportunity to temporarily replace Morales with someone with untainted integrity.
“We nonetheless call for President Duterte to put in charge a caretaker, who is an expert in the field of health insurance with proven integrity and incorruptibility – someone who is not himself or herself under investigation, someone devoid of vested interest,” PhilHealth-WHITE president Maria Francisco said.
“PhilHealth-WHITE cannot be subservient to executives whose integrity is in question,” she added.
On Duque, the employees union said, “The Chairperson of the PhilHealth Board, Department of Health Secretary Francisco Duque is no exception and should take a back seat being the subject of several investigations.
“By doing so, all doubts about whitewashing and cover-up would be dispelled, and we would therefore be ensured of a fair and honest investigation that will weed out the guilty, and not simply hang scapegoats,” added Francisco. – With Gerard Naval and Jocelyn Montemayor