PhilHealth: PSA declined to give data on dead beneficiaries

MANILA, Philippines — Philippine Health Insurance Corp. (PhilHealth) said on Wednesday that it tried to verify with the Philippine Statistics Authority (PSA) if a number of WellMed Dialysis Center’s patients had died, but the agency turned down its request.

Shirley Domingo, PhilHealth spokesperson, said the state health insurance firm asked the PSA late last year for data on patients supposedly used by the Quezon City-based dialysis center to make fake claims.

But the PSA, citing data privacy concerns, thumbed it down in January, according to Domingo.

“They advised us to talk to the relatives, and if they are authorizing us then we can get the evidence from them,” she said in an interview on Radyo Inquirer.

Under Section 13 of Republic Act No. 10173, or the Data Privacy Act, the processing of one’s personal information is permitted if it is “necessary to achieve the lawful and noncommercial objectives of public organizations and their associations.”

In his affidavit, former WellMed employee Edwin Roberto, who blew the whistle on the scheme first reported by the Inquirer, said the dialysis center had sought payments from PhilHealth by using the remaining treatments of patients who had died.

Roberto noted that WellMed was able to defraud PhilHealth because the insurance firm was “unable to know if a patient has died.”

That is why PhilHealth is drafting a memorandum of agreement with the PSA so the agency’s statistics can be shared with the health insurance firm, Domingo said.

“So, whether or not a complaint is filed with us or a provider falsely claims that [a patient] is still alive, we will know with the data shared by the PSA,” she said.

Domingo pointed out that such effort came about even before WellMed’s scheme was exposed. —Jovic Yee