President Rodrigo Duterte has ordered the prosecution of all individuals involved in an alleged scam in which PhilHealth benefits were being paid for bogus kidney dialysis treatments for “ghost” or non-existent patients.
Presidential Spokesman Salvador Panelo said Duterte expects the Philippine Health Insurance Corp. to initiate criminal actions against those involved in the apparent misuse of funds.
“We will put a stop to this corruption and we will make sure that the law on universal health care is strictly enforced,” Panelo said.
“All persons involved in the alleged fraud will be prosecuted and face accountability. They shall reap the harshest penalty imposed by law,” he added. “Nothing can shield them from prosecution and punishment.”
Earlier reports said PhilHealth was unaware that some of the beneficiaries have long been dead and continued to make payments to a private dialysis center in Novaliches, Quezon City.
The state insurance fund said it has already filed 28 administrative complaints against the WellMed Dialysis Center and Laboratory Corp., saying it had strong evidence of fraud when the company began claiming benefits on behalf of dead patients in 2016.
Roy Ferrer, acting president of PhilHealth, said the fund has also filed complaints against some doctors for their possible involvement in fraud. PhilHealth is also looking into filing 12 cases of fraudulent claims.
Ferrer then said that falsification and misrepresentation cases against the Quezon City-based medical center were already filed.
The Palace’s statement came after two whistleblowers, who are former employees of the WellMed dialysis center, exposed the fraud. Edwin Roberto, one of the whistleblowers, said PhilHealth turned them down when they sought assistance and protection.
Despite the complaints, PhilHealth still renewed WellMed’s accreditation for another year.
A spokesperson for PhilHealth said the bogus dialysis treatments were not isolated cases.
Interviewed on the GMA-7’s Unang Balita, Shirley Domingo said PhilHealth has been investigating more than 8,000 cases of fraudulent acts, involving ghost patients, false claims and misrepresentation of patients.
Former presidential spokesman Harry Roque, who has been assisting the whistleblowers, said negligent PhilHealth officials made the issue worse.
“This is gross negligence or they are playing blind,” he said, adding the two whistleblowers would file a case against PhilHealth officials over the issue.
If PhilHealth could not remove those officials engaged in alleged fraud and corruption from its ranks, Roque said he would call for the suspension of the Universal Health Care Act.
“Instead of losing our money to the corrupt, let’s suspend the law and start a thorough cleanup of PhilHealth,” said Roque, saying that as long as there was corruption, the UHC law would be ineffective.
But Ferrer said the expose was aimed at unseating him.
“It could be [an attack] against me and PhilHealth because of my focus now is on anti-fraud and the mandate that was given to me by the President himself and Congress to check on these frauds that are happening,” Ferrer said.
“Attorney Roque wants my post, [but] he has to earn it. Now, I, the acting president and CEO, have to carry out what the President told me to do.”
He denied that PhilHealth officials were not acting on the issue.
Outgoing Senator JV Ejercito, meanwhile, rejected Roque’s call to suspend the UHC Law. Roque, a former Kabayan party-list representative, was among the co-authors of the Universal Health Care bill in Congress.
“It will be unfair for the rest to be deprived of Philhealth’s services,” said Ejercito, chairman of the Senate committee on health and demography.
Ejercito was the principal sponsor and co-author of the UHC Law that would ensure health insurance coverage and expand benefit packages particularly for outpatient consultation and outpatient medicines for all Filipinos.
He said patients who badly need dialysis should not be made to suffer because of the allegations of fraudulent transactions within PhilHealth.
He said PhilHealth should continue providing health services, but it must ensure the authenticity of those who avail the services.
“The UHC Law just needs to be implemented,” Ejercito said, noting that the measure already provides stiff penalties for unethical and fraudulent transactions.
Bayan Muna Rep. Carlos Isagani Zarate said that government must investigate the alleged anomalies and corruption surrounding the PhilHealth-supported dialysis treatments.
“After our initial win in the passage of the bill for free dialysis treatments for the poor in the House of Representatives, we are concerned with reports of opportunism in the dialysis treatments supported by PhilHealth,” Zarate said.