PhilHealth fraud: Officials of private medical facilities also liable—Lacson

Officials and owners of private medical establishments that allegedly profited from fraudulent claims from Philippine Health Insurance Corp. (PhilHealth) are also criminally liable, but prosecuting them would be difficult without testimonies from witnesses, Sen. Panfilo “Ping” Lacson said on Friday.

Lacson said that charges could be filed if authorities were able to establish a “conspiracy and connivance” between PhilHealth officials and unscrupulous owners or officers of private hospitals, dialysis centers or maternity clinics to defraud the state insurer.

“But if there’s none, it would be hard to prove [the allegations],” he said in a radio interview.

P45M for dialysis center

“Who will testify? If either of the parties involved speaks about connivance, then it’s like an admission that a crime has been committed,” said Lacson, who initiated the latest Senate inquiry into the multibillion-peso corruption scandal that could financially cripple PhilHealth.

Lacson earlier said that the inquiry report by the Senate committee of the whole would include separate recommendations on actions to be taken against B. Braun Avitum Philippines Inc., a private dialysis center that received P45 million from PhilHealth’s special fund for COVID-19.

The senator, citing official documents, said B. Braun was able to obtain advance payments from the state-run insurance corporation’s interim reimbursement mechanism (IRM) without treating even a single patient for COVID-19.

The Senate had inquired into PhilHealth’s allegedly overpriced P2-billion information technology project and the misuse of the P30-billion IRM fund.

The inquiry and the investigations by the House of Representatives and a multiagency task force led by the Department of Justice were triggered by the resignation last month of PhilHealth antifraud officer Thorrsson Montes Keith, who said there was widespread corruption in the state corporation.

Keith alleged that up to P15 billion was pocketed by a syndicate operating in PhilHealth.

President Rodrigo Duterte earlier this week asked PhilHealth president and CEO Ricardo Morales to resign, noting the retired Army general’s failing health. Morales is undergoing treatment for cancer.

‘Public clamor’ vs Duque

PhilHealth Senior Vice President for Legal Sector Rodolfo del Rosario also resigned on Wednesday, a week after the Ombudsman suspended him and 12 other former and current officials for six months without pay.

PhilHealth Executive Vice President and COO Arnel de Jesus was appointed as Morales’ temporary replacement, which Sen. Francis Pangilinan blasted as a “band-aid solution” to the PhilHealth scandal.

De Jesus, also a key figure in the probes, had skipped two of the three Senate hearings, citing health reasons.

Pangilinan said the public was demanding the removal of Health Secretary Francisco Duque III, not just as the chair of the PhilHealth board but also as the head of an interagency task force handling the COVID-19 emergency.

“The public clamor is for a surgery of the cancer that is corruption, not just in PhilHealth, but in the government offices responsible for the procurement of overpriced and sometimes ineffective medical equipment, devices and supplies,” Pangilinan said.

2021 proposed budget

In a Viber message to the Inquirer, Sen. Joel Villanueva said he was urging other PhilHealth executives “to provide all the necessary support De Jesus needs so our state health insurance continues to provide service to our people as urgent as the times today necessitate.”

To finance PhilHealth’s operations in 2021, the Duterte administration allocated P71.35-billion from the national budget, the same amount it received this year.

In his budget message to Congress, the President said the money would strengthen the National Health Insurance Program next year.

He said the money would be used to subsidize the health insurance premiums of 7.3 million senior citizens and 13.22 million indigent families identified by the National Household Targeting System of the Department of Social Welfare and Development. —WITH A REPORT FROM JULIE M. AURELIO