The Philippine Health Insurance Corp. (PHilHealth) incurred more than P6.88 billion in audit disallowances that the Commission on Audit (COA) found to be irregular or outright fraudulent.

In its 2019 annual audit report, COA also said PHilHealth had overpaid hospitals, clinics, and other health care institutions amounting to over P936.65 million for the year in review.

COA noted overpayments in cases for dengue, urinary tract infection, and hypertensive emergency care.

However, the highest case of overpayment was for pneumonia that reached P105.93 million or a 117.67-percent difference from actual charges, with COA saying this was “highly unusual.”

Furthermore, COA’s audit revealed that PhilHealth employees received financial benefits totalling P198.238 million in 2015 that were not taxed.

“The corporation’s payment to this tax deficiency resulted in unjust enrichment on the part of the concerned employees at the corporation’s expense,” COA said, adding that
uncollected withholding tax from employees totaled P50.016 million.

The state auditors said the agency’s failure to collect the tax deficiency from employees may result in audit disallowances.

“As of December 31, 2019, the unsettled audit suspensions, disallowances, and charges of PhilHealth amounted to P84.364 million, P6.880 billion, and P2.420 milliion, respectively,” the COA report said.

PhilHealth is currently under fire over massive fraud and has been subjected to a probe led by the National Bureau of Investigation (NBI).

Last week, 43 PhilHealth senior officers tendered their resignations amid the declaration of its newly-appointed president and chief executive officer Dante Gierran that he would reorganize the embattled agency.

Gierran on September 30 issued a memorandum to implement a previous board solution “directing all senior officers from Salary Grade 26 and above to tender their courtesy resignation.”

The resignation of the 43 PHilHealth senior officials came days after Justice Secretary Menardo Guevarra said more persons would be charged by the Task Force PhilHealth which is looking into irregularities as its investigation goes deeper into the state insurer’s affairs.

Last week, the NBI formally endorsed to the Office of the Ombudsman the complaint against former PhilHealth president and chief executive officer Ricardo Morales and other senior officials including executive vice president Arnel de Jesus, senior vice president Renato Limsiaco, senior vice president Israel Francis Pargas and vice presidents Gregorio Rulloda, Imelda Trinidad de Vera, Lolita Tuliao, Gemma Sibucao, and Lailani Padua.

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