OFFICIALS of the Philippine Health Insurance Corp. (PhilHealth), led by president and CEO Ricardo Morales, have waived their right to bank secrecy and allowed the Anti Money Laundering Council (AMLC) to look into their bank records amid allegations of widespread corruption in the agency.
This was disclosed yesterday by Rep. Mike Defensor (Anakalusugan party-list), chair of the House committee on public accounts, during a joint hearing of his panel and the committee on good government and public accountability chaired by Bulacan Rep. Jonathan Sy-Alvarado.
“They are giving the investigators the authority to look into their bank accounts,” Defensor said.
Defensor’s disclosure came after six regional vice presidents of the state insurer were reported to be going on leave, effective yesterday, to give way to investigations into alleged corruption at the agency.
PhilHealth spokeswoman Dr Shirley Domingo, PhilHealth vice president who was among those who signed a waiver, said members of PhilHealth’s executive committee are also planning to go on leave.
“Actually, it’s not just the six vice presidents, even the execom members will also take a leave,” said Domingo in a radio interview yesterday morning.
It was not yet clear who will go on leave.
In a message yesterday afternoon, Domingo said, “I’m correcting myself from the interview this morning. Execom members still have to attend scheduled Congress hearings this week.”
Thorrsson Montes Keith, who recently resigned as PhilHealth anti-fraud legal officer, earlier told a Senate hearing that all members of PhilHealth’s executive committee composed the “mafia” which has siphoned off some P15 billion in the agency’s funds in 2019 alone.
Defensor said aside from Morales and Domingo, the 12 other officials who have signed their waivers are executive vice president and COO Arnel de Jesus, senior vice presidents Dennis Mas, Rodolfo del Rosario Jr., Jovita Argona, Renato Limsiaco Jr., Israel Francis Pargas, acting SVP Nerissa Santiago, vice president Oscar Abadu, corporate secretary Jonathan Mangaoang, senior manager Bernadette Lico, and area VPs Franciso Soria and Walter Bacareza.
In last week’s hearing, Morales, De Jesus and Del Rosario failed accept the challenge of deputy speaker Luis Raymund Villafuerte (Camarines Sur) for all top officials of the agency to waive their right to bank secrecy and allow the AMLC to check their bank records.
Several minutes into last week’s joint hearing, the three asked the committees to be excused from participating in the hearing via Zoom app for various medical reasons.
Morales, who wrote the joint panel to apologize, said he had to leave early last hearing because he had just undergone a chemotherapy session and was still dizzy.
Defensor thanked the retired military general for participating in the hearings despite his condition, saying the House is praying for him.
“We hope that through this hearing and the hearings in the Senate, the investigation of the DOJ (Department of Justice), makamtan natin ang mga reporma at pagbabago na gusto natin sa lahat (we’ll achieve the reforms and changes we all want),” he said.
At one point in the hearing yesterday, the meeting had to be suspended to excuse Del Rosario whose blood pressure shot up once again and De Jesus, who complained of weakness as he said he just had his pacemaker replaced.
Defensor said 51 hospitals that are facing fraud cases have been given a total of P1.4 billion by PhilHealth through the interim reimbursement mechanism (IRM) from 2013.
The IRM, which is allegedly being used by the PhilHealth to siphon off money, was suspended last week by the agency. Under the IRM, PhilHealth pays hospitals and other healthcare facilities in advance for the insurance claims of PhilHealth members, to ensure their liquidity during crises, like the COVID-19 pandemic.
PhilHealth board member Alejandro Cabading, a whistleblower, said that like congressmen, he, too was taken aback as the schedule of liquidation was not even discussed by the management which even issued a memorandum making liquidation of IRM optional.
The IRM has P30 billion in funds. PhilHealth has made advance payments of P14.9 billion to healthcare institutions but only around P1 billion has been liquidated.
“With so many hospitals here in Metro Manila, in other provinces, we should not allow those that have fraud cases, those that have penalties, to continue to have such funds,” Defensor said.
PADDING, POST-DATING CLAIMS
Defensor said that based on PhilHealth records, there are 4,664 cases of fraud against different hospitals, of which 768 were reported from 2013 to 2018 and 3,806 were filed by PhilHealth between 2019 and 2020.
These cases include padding of claims, claims for non-admitted or non-treated patients, extending the period of confinement, post-dating of claims, misrepresentation by furnishing incorrect information, unjustified admission beyond accredited bed capacity, unauthorized operations beyond service capability, fabrication or possession of fabricated forms and supporting documents and other fraudulent acts at criminal liability.
Defensor said these hospitals and health facilities include Capitol Medical Center, Cardinal Santos Medical Center, St. Luke’s Medical Center, The Medical City, Marikina Valley Medical Center, Manila Doctors Hospital, Perpetual Succor Hospital and Maternity Inc., Angono Medical Center, Asian Renal Care Philippines, B. Braun Avitum Philippines Inc., Eastern Marikina Dialysis Center, Our Lady of Lourdes Hospital, St. Benedict Dialysis Center, Inc., Holy Trinity Medical Center, St. Louis Hospital in Sultan Kudarat, Baguio Medical Center, FEU Dr. Nicanor Reyes Medical Foundation, Inc. and others.
Senate President Vicente Sotto III said the five Cabinet secretaries who are ex-officio members of PhilHealth were invited for today’s third Senate hearing.
They will be asked about the IRM, he said.
The five Cabinet secretaries who are ex-officio members of PhilHealth are Health Secretary Francisco Duque III, Labor Secretary Silvestre Bello III, Finance Secretary Carlos Dominguez III, Social Welfare Secretary Rolando Bautista, and Budget Secretary Wendel Avisado.
Sen. Christopher Go, chair of the Senate committee on health and demography, said PhilHealth officials implicated in the alleged anomalies should be placed under preventive suspension so they could not influence the outcome of investigations conducted by Task Force PhilHealth, a probe body headed by Justice Secretary Menardo Guevarra ordered created by President Duterte.
“I think the problem here is that our investigative bodies cannot freely move because those who are allegedly involved are still in their posts,” he said in Filipino.
Go also said he welcomes the move of the six regional VPs to go on leave. — With Raymond Africa