MANILA, Philippines – The National Bureau of Investigation (NBI) has filed before the Department of Justice (DOJ) a criminal complaint against 21 officials and employees of the Philippine Health Insurance Corporation (PhilHealth) in connection with the reported ghost dialysis claims.
At a press conference, NBI Deputy Director Vicente De Guzman said facing a case for violation of Republic Act 3019 or the Anti-Graft and Corrupt Practices Act, RA 10606 or the National Health Insurance Act of 2013 and RA 6713 or the Code of Conduct and Ethical Standards for Public Officials and Employees are the members of the Accreditation Sub-Committee from PhilHealth Regional Office National Capital Region(PRO-NCR).
The PRO-NCR is supposedly responsible for approving the accreditation of WellMed for 2019 despite investigations conducted by PhilHealth’s Fact-Finding Investigation and Enforcement Department on the allegedly fraudulent claims of WellMed.
“PRO-NCR did not conduct periodic monitoring of the Health Care Institution (HCI), as in this case WellMed,” said the NBI. Periodic monitoring means conducting utilization review and/or visitation of the facility by the inspecting team.
The NBI added that despite a recommendation to withdraw the accreditation of WellMed, the PhilHealth’s Accreditation Sub-Committee continue to process its claims.
De Guzman said the case they have filed only pertains to WellMed.