MANILA – The inter-agency task force investigating irregularities in the Philippine Health Insurance Corp. (PhilHealth) on Monday submitted its 177-page initial report to President Rodrigo Roa Duterte.
“As the task force awaits any further directives from the President, its composite team will pursue further targeted investigations of specific acts of fraud or corruption committed by health providers and PhilHealth personnel alike,” said Justice Undersecretary Neil Bainto in a statement.
He added that “already pending complaints and cases shall be resolved by the agencies concerned with dispatch”.
Formed last August 7, the task force conducted seven hearings where it received the testimony of 14 witnesses, reports and summaries of cases, and reports and recommendations of other bodies including the Senate.
Guevarra earlier said newly-appointed PhilHealth chief Dante Gierran’s administrative skills and fiscal prudence would help in wiping out irregularities in the state insurer.
Duterte has ordered Gierran to find the officials and persons responsible for irregularities in PhilHealth and has directed a reshuffle of the state firm’s regional vice presidents.
During the investigation, the task force called out the state firm’s alleged “foot-dragging” in going after thousands of fraud cases involving its employees and some healthcare institutions (HCIs) and has flagged the low and slow rate of prosecution of cases by PhilHealth’s legal office.
The task force noted the thousands of cases against erring PhilHealth employees and HCIs which remain unfiled.
Resigned Senior Vice President for the Legal Sector, Atty. Rodolfo del Rosario Jr. confirmed that while there are thousands of administrative cases against PhilHealth employees in the corporation’s case inventory, only 70 cases have been ‘processed,’ and only 50 have resulted in the issuance of formal charges.
The DOJ said one notable case against PhilHealth employees involves claims worth around PHP2.1 billion.
Del Rosario, in his appearance before the fact-finding body, reported that there are around 1,700 cases in PhilHealth’s case inventory involving HCIs.
He said his office has reviewed and endorsed 1,003 cases for filing of criminal complaints by the regional offices. He admitted that only 11 cases have been filed to date.
Losses related to cases involving HCIs including fraudulent claims is estimated at around PHP4.7 billion.
The Governance Commission for Government-Owned and -Controlled Corporations (GCG) has previously given the PhilHealth legal sector a zero rating in its 2017 and 2018 evaluations because of delays in the filing of cases.
The team will, among others, audit and validate the case inventory of PhilHealth, and recommend, if warranted, the start of administrative, civil and/or criminal action against the corporation’s employees and HCIs. (PNA)