MANILA, Philippines — Correcting the interim reimbursement mechanism (IRM) of the Philippine Health Insurance Corp. (PhilHealth) is important, but Sen. Panfilo Lacson insists that officials responsible for irregularities should also be held criminally liable.
Lacson said on Wednesday that those responsible for the faulty IRM should be made accountable, especially since it supposedly facilitated billions of advance payments to unauthorized health care institutions (HCIs) while the COVID-19 pandemic was ongoing.
Lacson pointed out in a Senate hearing that the IRM should not cater to non-COVID-19 cases since such mechanism only covered “fortuitous” or unforeseen events — like the pandemic, which popped only in late 2019 and progressed by the first quarter of 2020.
In this case, other medical conditions — like pregnancy and kidney ailments — should not be covered by the IRM. But it was found out that dialysis and maternity facilities were included among sectors that could receive IRM funds.
“More than rectifying the wrong implementation of the IRM Circular 2020-0007, the accountable officers of PhilHealth who were responsible for the advance payments worth billions of pesos from March to July made to unauthorized HCIs like dialysis centers, maternity care providers, etc., should be made criminally and administratively liable for malversation of public funds,” Lacson said.
Eventually, Health Secretary Francisco Duque III, who was present in the hearing as chairperson of PhilHealth’s Board of Directors, told Lacson that the officials would rectify the errors in the IRM.
“The evidence supported by official documents and testimonies provided by resource persons who testified under oath so far gathered by the Senate Committee of the Whole during the three weekly hearings are enough to indict people responsible directly or otherwise,” Lacson added.
“Without tough punitive action against those involved in such shenanigans, we may never see the end of the vicious cycle of corruption that has plagued PhilHealth,” he noted.
The issue of dialysis and maternity clinics being covered by PhilHealth came out last Monday after lawmakers from the House of Representatives questioned why funds were being diverted to dialysis and maternity clinics even if they were not servicing COVID-19 cases.
This issue is the latest in a string of controversies hounding the state-owned health insurance company, which all came out after one of its officials resigned last July 23 due to widespread corruption within the agency.
The official, who eventually turned out to be anti-fraud officer Thorrsson Montes Keith, said that members of a “mafia” within PhilHealth had already pocketed more than P15 billion in funds.
It was also revealed that some of PhilHealth’s procurements were overpriced — including an Adobe master collection software priced at P21 million — 12,400 times higher than the normal cost.
But this is not the first time PhilHealth under the current administration has been rocked by corruption scandals.
In 2019, the Philippine Daily Inquirer ran a series of investigative reports showing a scheme under which already dead patients were still undergoing dialysis and making claims from PhilHealth.
Officials of PhilHealth said that the corporation might collapse by 2022 if the COVID-19 pandemic would persist. However, Marikina Rep. Stella Quimbo said that a collapse would only happen if computations for expected expenses were overestimated — which would also open avenues for corruption.
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