NBI arrests WellMed owner over ghost dialysis issue

MANILA, Philippines —The owner of a private dialysis center who has been accused of defrauding Philippine Health Insurance Corp. (PhilHealth) by submitting claims for dead patients was arrested on Monday.

Bryan Christopher Sy of WellMed Dialysis Center in Novaliches, Quezon City, was  arrested when he showed up at the National Bureau of Investigation  headquarters in Manila.

President Duterte had ordered Sy’s arrest and instructed PhilHealth’s acting chief, board members and regional vice presidents to hand in their courtesy resignations or be fired.

“On Saturday night, I was ordered by the President to tell them to just submit their courtesy resignation. All of them, all the board members of the PhilHealth,” said Mr. Duterte’s longtime aide, Senator-elect Christopher Go.

On Monday night, Mr. Duterte demanded the resignation of the entire PhilHealth board during a meeting in Malacañang, presidential spokesperson Salvador Panelo said.

Panelo said the President wanted “a clean slate” in PhilHealth.

Mr. Duterte gave the order to arrest the owners of the private dialysis center on Saturday over claims made by two former employees that it had been defrauding PhilHealth.

“The sheer amount of 100 something billion [pesos] is totally, totally unacceptable to me,” he said as he noted that many ailing Filipinos depended on PhilHealth.

His directive was in response to the Inquirer’s three-part investigative report last week about fictitious patients, PhilHealth losses of P154 billion between 2013 and 2018 due to overpayment and fraud, and a “mafia” behind the padded claims.

Whistleblowers, too

In an unexpected turn, whistleblowers Edwin Roberto and Liezel Santos were also  arrested on Monday.

Like Sy, Roberto and Santos would be charged with estafa and falsification of documents in the Department of Justice on Tuesday.

An NBI agent explained that the whistleblowers had to be  charged in court first so they could be tapped as state witnesses.

After the filing of charges, they would be discharged as state witnesses depending on the evaluation of the trial judge.

Roberto earlier said owners of WellMed had told employees to forge signatures of patients who had died on the medical claims the center submitted to the state health insurance firm.

In an affidavit, Roberto said WellMed made successful benefit claims on dialysis package for the dead patients.

No warrant

There was no warrant against Sy, who came to the NBI after being invited for questioning on the  dialysis scam. He came to the bureau’s antigraft division about 11 a.m., together with his lawyer Ruel Ilagan.

At 4 p.m., right after PhilHealth investigators brought to the NBI a boxload of documents that allegedly proved there was a scam, Sy was arrested.

Sy, who wore jeans, a pair of black sneakers and gray polo shirt, declined to be interviewed. When asked for comment, he just said: “Sorry, I’m very tired.”

Nathaniel Ramos, head of NBI’s antigraft division, said the arrest, although without warrant, stemmed from the doctrine of continuing crime.

He added that the PhilHealth claims made by WellMed were still pending so the crime was continuing.

Monday was the first day of the NBI’s probe of the scam. PhilHealth stands as the main complainant in the case.

This meant that PhilHealth investigators, led by lawyer Eduardo Barbado Jr., only submitted documents on Monday.

“Can they be arrested without warrant?” the Inquirer asked. “Well, that’s the new doctrine now,” said another source, who laughed and shook his head.

Probable cause

Although the documents, which were stuffed in a brown box, were incomplete, a source said the bureau, upon checking them, “found probable cause” to arrest Sy.

Barbado said the documents, including fraudulent claim forms, were taken to the NBI because these had been subpoenaed by the bureau.

Justice Secretary Menardo Guevarra has ordered the NBI to also investigate hospitals and clinics that connived with PhilHealth officials and staff to defraud the public health insurance fund.

Mr. Duterte himself has ordered the NBI to investigate alleged irregularities at PhilHealth, Panelo said.

The President is looking for replacements for the PhilHealth chief and board members, preferring a retired female doctor from the police or military to head the board.

He also wants a “strict manager” to handle the state health insurer’s funds, Go said.

Although the President still trusts PhilHealth president Roy Ferrer, whom he appointed in July 2018, Go said Mr. Duterte was “dismayed” over the misuse of the PhilHealth funds to pay for dialysis of deceased patients.

“Dr. Ferrer is a physician of the President and he’s very honest. It just happened that his men below him pulled one over him. But it’s command responsibility. They let this happen since 2016,” Go said.

PhilHealth revamp

He said he would recommend to the President a top-to-bottom revamp in PhilHealth and the suspension of the implementation of the Universal Health Care (UHC) law, “especially that we have not yet found a trustworthy official to handle PhilHealth funds.”

PhilHealth is mandated to implement the UHC law, which automatically provides health insurance to all Filipinos and gives them access to a full spectrum of medical services. —WITH REPORTS FROM DONA Z. PAZZIBUGAN AND DJ YAP

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