The PhilHealth mess: Is Duque accountable? (Conclusion)

The PhilHealth mess: Is Duque accountable? (Conclusion)"There is no way he can distance himself from the agency’s problems.



Last week, my piece discussed the various ways by which PhilHealth officials may have been involved in corrupt practices involving huge amounts of members’ contributions and public funds. Included were the Interim Reimbursement Mechanism (IRM), the case-rate system of paying health care institutions (HCIs), the anomalous practices of the information and technology sector, and the violation of PhilHealth mandate as regards providing services to our overseas Filipino workers (OFWs).

As mentioned, under Article IV, Section 6 of RA 7875 as amended by RA 10606, one of PhilHealth’s functions is, “u) To establish an office, or where it is not feasible, designate a focal person in every Philippine Consular Office in all countries where there are Filipino citizens. The office or the focal person shall, among others, process, review and pay the claims of the overseas Filipino workers (OFWs).” This mandate is being outrightly circumvented by PhilHealth by implementing another scheme using Accredited Collecting Agents (ACAs).

In the COA letter to the agency dated July 31, 2019, the audit report comments for 2017 and 2018 included the following:

The completeness and accuracy of the collections remitted by ACAs to PhilHealth amounting to P53.736 billion were doubtful.

There was a discrepancy of P1.667 billion between the recorded collections by ACAs totaling P53.796 billion, and the Report of the Treasury Department amounting to P55.463 billion.

PhilHealth failed to do monitoring and accounting of used (PhilHealth Agents Receipt) PARs distributed to 7,468 ACAs in the country and abroad. This cast doubt on the Premium Contributions account for 2018 (P132.463 billion) and related accounts.

112,957 sets of PARs for 2018 were reported by PhilHealth and ACAs as damaged, cancelled or lost.

The face value of these PARs was P27,109,680,000.00 (P27.109 billion). This is the amount that potentially could have been lost IF those receipts were not really lost but were fraudulently used or faked. It is unthinkable that this huge number of PARs could not be accounted for. At the very least, this proves that the PhilHealth process for OFWs was not working.

PhilHealth’s collections from OFWs from 2014 to 2017 continuously dropped in significant amounts. From PhP1.774 billion in 2014, PhP1.283 billion in 2015, PhP823.462 million in 2016, and PhP465.177 million in 2017.

The COA comment on “lost” PARS was for the year 2018 which means that the lost receipts could have been in use during preceding years when collections took a big dive.

The COA comment on lost PARs is most important especially in the light of the Joint Complaint Affidavit filed by Mr. Ken Sarmiento with the Office of the Ombudsman. Mr. Sarmiento was the head of the PhilHealth’s POEA-OFP Operations Office. Between 16 September 2015 to 19 September of 2018, his office discovered 224 fake PhilHealth Official Receipts (POR) issued by Liaison Officers of several land-based hiring agencies. An additional 868 photocopies of questionable PORs were found to carry false and fictitious transaction details.

These discoveries and the failure or refusal of responsible PhilHealth officials to act on Mr. Sarmiento’s reports and affidavits in the last five years raise questions on the connection of the fake receipts with those receipts used by ACAs and were reported “lost” by PhilHealth.

Were the faked receipts and those with fraudulent entries discovered by Mr. Sarmiento’s office among those reported as lost, damaged, or cancelled? Were the amounts of collected OFW premiums really dipping? Or, was the recorded significant decrease in the collection caused by faking receipts? Was this the reason why PhilHealth officials failed to take action on Mr. Sarmiento’s reports?

If this scheme indeed happened, it could not be done by ACAs without help from scrupulous PhilHealth insiders. Then it is possible that the so-called mafia involved in graft and corruption is real.

Earlier this week, the Inter-Agency Task Force (IATF) on COVID-19 came out with its recommendations regarding the PhilHealth mess. The IATF wants to file administrative and criminal charges against some of the agency’s top officials for graft, malversation of public funds, dishonesty, and grave misconduct.

Among the possible respondents is former President and Chief Executive Officer (CEO) retired General Ricardo Morales. What is quite noticeable is the exclusion of Health Secretary Francisco Duque from those that IATF wants to be held accountable. This is expected since Duque is the CHAIR of the IATF.

It is important to emphasize that Duque is the ex-officio Chairman of the PhilHealth Board of Directors. He was President and CEO from 2001-2005. As DOH Secretary, he was ex-officio Chair of the Board from June 2005 to January 2010. He was Chair of Civil Service Commission from 2010 to 2015 and from 2013, the CSC Chair also became an ex-officio PhilHealth Board member per R.A. 10606. He was back as ex-officio Chair of the Board from October 2017 to the present. Sec. Duque has been in PhilHealth for about 16 long years, and as Chair or President and CEO for almost 13 years.

For the length of time that the secretary has been with the PhilHealth Board, it is almost unbelievable that he remained completely unaware of the shenanigans in the agency. If this is the case, then he has been remiss in the performance of his responsibilities.

PhilHealth is an attached agency of the Department of Health (DOH). Duque has been in PhilHealth as the so-called mafia was bleeding the agency dry. Even just in terms of command responsibility, there is no way that Sec. Duque can distance himself from the agency’s problems.

Like the others, Duque is accountable for the PhilHealth mess.

@bethangsioco on Twitter Elizabeth Angsioco on Facebook

Topics: PhilHealth , Interim Reimbursement Mechanism , overseas Filipino workers
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