THE unsettled disallowances of the Philippine Health Insurance Corp (PhilHealth) have reached P7.858 billion as of December 31, 2022, the Commission on Audit disclosed.
According to the data posted by the audit team, the largest part of the disallowed sum are cash gifts, allowances, assistance, stipends, Christmas and birthday packages, and bonuses paid to officials and employees without legal basis or lacking the required prior approval of the President.
Other disallowed amounts consist of unauthorized or excess payments to suppliers or contractors.
The 51-page breakdown provided in a separate section of the 2022 audit report showed the PhilHealth Head Office incurred the biggest total of disallowances at P1.9 billion or 24 percent of the total followed by PhilHealth Region 3 (Central Luzon) with P610.47 million.
A notice of disallowance (ND) includes a requirement for persons held liable to refund the disallowed amount.
The full breakdown of the P7.868 billion unsettled disallowance:
PhilHealth Head Office – P1.9 billion; National Capital Region (NCR) & Rizal – P604.09M; Cordillera Administrative Region (CAR) – P340.055M; Region 1 (Ilocos Region) – P227.52M;
Region 2 (Cagayan Valley) – P339.13M; Region 3 (Central Luzon) – P610.47M; Region 4A (except Rizal) – P285.33M; Region 4B (Mimaropa) – P358.78M; Region 5 (Bicol Region) – P459.794M; Region 6 (Western Visayas) – P598.08M;
Region 7 (Central Visayas) – P283.6M; Region 8 (Eastern Visayas) – P275.4M; Region 9 (Zamboanga Peninsula) – P253.05M; Region 10 (Northern Mindanao) – P471.34M; Region 11 (Davao Region) – P347.57M; Region 12 (Soccsksargen) – P56.6M; Caraga — P408.04M; and Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) — P38.3M.
Part of the disallowances date back more than 15 years as the PhilHealth fought COA hard to lift the NDs filing multiple appeals and contesting the commission’s rulings all the way to the Supreme Court.
Among those that have been resolved by the SC affirming COA’s orders for refund against PhilHealth were the grant of birthday gifts, special events gifts, nominal gifts, educational assistance allowance, liability insurance coverage to Philhealth officials and Board members, Corporate Transition and Achievement Premiums, medical mission critical allowances, and efficiency gifts.
On the other hand, disallowances already covered by Notices of Finality of Decision or with COA Order of Execution include institutional meeting expenses, anniversary gifts, productivity incentive bonuses, Christmas packages, PS We Care benefits, allowances for contractors and project-based hires, shuttle service allowance, birthday gifts, grocery allowances, representation and transportation allowances.
In all these cases, those who were held liable for approving the irregular extra compensation were board members, its officers and employees, hence all are required to refund the disallowed sums in part or in full.
The rest of the unsettled amounts are still under appeal with the COA Commission Proper or with pending petitions for certiorari before the SC.
Other than the disallowances, the audit team also issued notices of suspension against PhilHealth transactions amounting to P158 million as of the yearend 2022.
