The Justice department has admitted to the witness protection program two whistleblowers who said their former employer, WellMed Dialysis and Laboratory Center, collected hundreds of millions of pesos worth of claims from the Philippine Health Insurance Corp. for bogus treatments for deceased members.
Justice Secretary Menardo Guevarra said the coverage for Edwin Roberto and Liezel Aileen de Leon would be provisional and “good for 90 days” while the DOJ conducts a preliminary investigation on seven other WellMed personnel charged by the National Bureau of Investigation with estafa and falsification of public documents.
The DOJ earlier indicted Roberto and De Leon along with WellMed’s co-owner Brian Sy with the same charges.
Other respondents–WellMed executives 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–to a separate preliminary investigation.
Former Presidential Spokesman Harry Roque, who is serving as legal counsel for Roberto and De Leon, said they would seek inclusion in the WPP.
Their sworn statements have become the basis for the indictment of Sy and the other respondents.
It will be up to the court to decide whether Roberto and De Leon would become state witnesses, depending on the arguments of the prosecution.
Under the law, a person wanting to be admitted into the WPP must execute a sworn statement describing in detail the manner in which the offense was committed and his or her participation.
If the DOJ is satisfied with the sworn statement and the applicant is the least guilty of the alleged crime committed, the person can be admitted into the program.
A person formally included in the WPP coverage may be provided housing or a safe house that can be extended to family members, financial assistance, assistance in obtaining a means of livelihood, and payment equivalent to his or her salary as compensation for absences in work, travel expenses and medical expenses.
Witnesses under WPP who die would also be given death benefits, including free college education for their children.
Meanwhile, Surigao del Sur Rep. Johnny Pimentel urged the Bureau of Internal Revenue to go after people who file fraudulent claims with PhilHealth.
“Sharks are circling PhilHealth because it is clearly vulnerable, plus it has the money,” he said.
“Those scamming Philhealth are easily 10 times more likely to be cheating on their taxes as well,” he said.
He urged PhilHealth to reinforce its risk controls against bogus claims.
“There will always be people trying to defraud PhilHealth. Thus, PhilHealth should develop a robust system to quickly spot and nip these rackets in the bud,” he said.
The House of Representatives has given PhilHealth another P67.4 billion this year to carry out the National Health Insurance Program, he said.
“Of course, the best way to fight these scammers is to prosecute them and put them all behind bars. PhilHealth should also refer all fraud cases to the BIR for appropriate action,” he said.
He was reacting to the recent discovery of ghost claims for kidney dialysis treatment.
A private health-care provider in Quezon City was found routinely claiming PhilHealth payments for dialysis procedures on deceased patients.
In 2015, PhilHealth officials told a Senate hearing that several eye-care centers were found seeking large payments for cataract surgery.
