NBI to probe other fake PhilHealth claims

PREMIUM ON PATIENCE Relatives of patients submit PhilHealth forms at Rizal Medical Center in Pasig City. —LYN RILLON

MANILA, Philippines — After suing a Quezon City dialysis center for getting payments for fictitious claims, the National Bureau of Investigation will investigate other medical centers that may also have defrauded Philippine Health Insurance Corp. (PhilHealth), Justice Secretary Menardo Guevarra said on Sunday.

Guevarra said he had ordered the NBI to expand its investigation of the PhilHealth scam by checking “suspicious claims” filed by other hospitals and medical clinics.

He said the NBI would need the cooperation of the new PhilHealth officials and other whistleblowers.

“My directive to the NBI covers not only WellMed (Dialysis and Laboratory Center) but also other clinics and hospitals. After WellMed, the NBI will investigate other suspicious claims,” Guevarra said.

“Hopefully, the NBI can get the assistance of the new PhilHealth management team,” he added.

P154B lost

PhilHealth, the national health insurer, is believed to have lost P154 billion by paying fraudulent claims.

The Department of Justice (DOJ), acting on the NBI’s complaint, on Friday brought charges of estafa and falsification of documents against the owner and two former employees of WellMed for getting P808,600 in reimbursements from PhilHealth for what the two former employees claimed were dialysis treatments for deceased patients.

Dr. Bryan Sy, owner of WellMed, and the two former employees — Edwin Roberto and Liezel Aileen de Leon — who turned whistleblowers were arrested on June 10.

Seven members of the WellMed board are facing preliminary investigation in the DOJ.

The NBI investigation and the arrests followed the Inquirer’s publication of a series of reports on the dialysis scam earlier this month.

Sy, 32, was released on Sunday after the NBI confirmed that he had posted P72,000 bail at Branch 6 of Manila Regional Trial Court.

While the NBI treated PhilHealth as the complainant in the case against WellMed, Guevarra said the bureau would also look into possible criminal liability of PhilHealth officials and employees who may have been involved in the scam.

Last week, PhilHealth President and Chief Executive Officer Roy Ferrer and six board members resigned on President Duterte’s orders.

‘Double standard’

Mr. Duterte, however, did not demand the resignation of Health Secretary Francisco Duque III, chair of PhilHealth.

For Sen. Panfilo Lacson, that is “double standard.”

Lacson, known for his crusade against pork and other forms of corruption in the government, insisted that Duque should have turned in a courtesy resignation after Mr. Duterte demanded the departure of the other PhilHealth officials.

He also noted that Duque had admitted to being godfather to Sy.

“[Duque] has lost that opportunity to show propriety. He should have done that when all the members of the PhilHealth board, which he chairs, were asked by the President to submit their courtesy resignation,” Lacson said.  —WITH REPORTS FROM AIE BALAGTAS SEE AND MARLON RAMOS