The co-owner of WellMed Dialysis and Laboratory Center, accused of billing the Philippine Health Insurance Corp. more than P800 million for bogus dialysis treatments for members who were already dead, will remain detained, a Manila court and the Justice department said Wednesday.
Bryan Sy, one of the owners of WellMed, was arrested Monday, but his lawyers sought his release during inquest proceedings at the Justice Department, arguing that his arrest without a warrant was illegal.
But Senior Assistant State Prosecutor Anna Noreen Devanadera denied the plea, citing the decision of Manila Regional Trial Court Branch 20 to deny the respondent’s petition for the writ of habeas corpus.
The court’s ruling, Devanadera said, upheld the validity of Sy’s arrest.
Sy’s camp did not submit any evidence to counter the NBI’s complaint, which was then submitted for resolution.
“In the meantime, respondent will be detained at the NBI detention center while awaiting for the resolution of this case,” Devanadera said.
In its ruling, the Manila court denied the petition for habeas corpus filed by Sy’s wife Therese Francesca, who questioned the validity of the WellMed owner’s arrest while he was undergoing interrogation in NBI.
After hearing the petition, Judge Marivic Balisi-Umali found no basis to grant the plea.
Sy and other WellMed officers were charged before the DOJ with estafa and falsification of documents under the Revised Penal Code.
Aside from Sy, the NBI complaint named other WellMed executives as respondents: Dr. John Ray Gonzales, medical director; Claro Sy, chairman; Alvin Sy, corporate treasurer; Therese Francesca Tan,
purchasing officer; Dick Ong, administration officer; and physicians Porshia Natividad and Joemie Soriano.
The charge sheet also listed whistleblowers Edwin Roberto and Liezel Aileen Santos, who exposed the clinic’s alleged “ghost dialysis scandal” and whose affidavits became basis of the charges.
Harry Roque, lawyer of the two former employees of WellMed, revealed that his clients would seek coverage under the DOJ’s witness protection program.
In an interview after the hearing, Roque said PhilHealth executives who were asked by President Duterte to resign should have been charged before the DOJ also.
Justice Secretary Menardo Guevarra on Wednesday said the two former WellMed employees who exposed the alleged scam could be admitted into the government’s Witness Protection Program but said it was too early to consider the possibility.
In its complaint, the NBI alleged that the clinic received payments from PhilHealth for dialysis treatments even though some of the patients have long been dead.
Roberto, previously the assistant manager of Wellmed, claimed in his sworn statement that it was Sy himself who ordered him on March 30, 2016 to try to charge PhilHealth with claims of two dead patients amounting to P2,600. It was De Leon whom he instructed to prepare the forms.
In his affidavit, Roberto revealed that before he resigned in March 2018, PhilHealth paid WellMed a total of P600,600 consisting of 200 sessions from dead patients.
There was also an unpaid claim of P208,000 for 80 sessions, which he said was eventually paid.
In all, Roberto said PhilHealth settled a total of 27 claims amounting to P808,600.
The NBI also submitted the sworn statement of John Cueto, a PhilHealth special investigator, who said WellMed continues to PhilHealth reimbursement forms for their patients.
Former Health secretary Janette Garin on Wednesday said PhilHealth officials and doctors were also involved in ghost claims worth P16,000 to P32,000 for fictitious patients supposedly for the treatment of pneumonia, cataract and dengue treatment.
“Truth is, they just get claimants, feed them and give them the fare, and they will just be happy receiving P500,” she said.
When she was in office, she added, her technical people put in place a computer-based dashboard that showed with one click the hospitals and doctors whose claims had drastically gone up.
“By seeing the sudden increase of claims, we could immediately order a stop payment and conduct investigation” she said.
She said she could present the appropriate documents to prove her claims.
Garin said the Department of Health had failed to file criminal charges against ghost dialysis firms, and instead just imposed fines. This allowed them to continue with their fraudulent activities, she added.
“The bottom line here is that there is a serious illness within PhilHealth. There are too many good people inside who continue to bear the brunt [of the irregularity]. There have too many Filipino people getting deceived,” she said.
“Let’s open PhilHealth to scrutiny in and out,” she added.
Meanwhile Citizens Battle Against Corruption Party-list Rep.-elect Eddie Villanueva condemned PhilHealth and WellMed officials and said more measures should have been in place to stop fraudulent transactions.
Anakalusugan Party-list Rep.-elect Mike Defensor, on the other hand, said the dialysis scam was not an isolated cases, saying a “pneumonia scam” was also plaguing PhilHealth.
“While last year, the Department of Health claimed that there was no pneumonia epidemic, P10 billion was paid by PhilHealth to hospitals and other health care providers,” Defensor said.
He said stealing from PhilHealth was worse than plunder.
“Every centavo stolen means depriving another person’s life,” he said.
“This is also gross negligence on the part of PhilHealth personnel who allowed this to happen. All persons involved in this scam must be held accountable and meted out the highest penalties provided by law. Those who usurp funds meant for the sick and the needy should be arrested and charged to prevent future occurrences of this nature,” he added.
Senator Richard Gordon, chairman of the Senate Blue Ribbon committee, said stiffer penalties should be imposed on fraudulent health benefit claims.
Gordon, also the chairman of the Philippine Red Cross, said he was “completely devastated” by revelations of widespread fraud in the claiming of PhilHealth benefits.
Senators Panfilo Lacson and Juan Edgardo Angara called for corrective and punitive measures.
Angara said hospitals and wellness centers would not make fraudulent claims without knowing someone inside PhilHealth. He added that the safeguards against fraud were weak.
