De Lima calls for ‘full-blown’ probe into ‘questionable’ PRC-PhilHealth deal

MANILA, Philippines — Alleged irregularities in the multi-million agreement between the Philippine Health Insurance Corp. (PhilHealth) and Philippine Red Cross (PRC), chaired by Senator Richard Gordon, warrants a “full-blown” investigation, Senator Leila de Lima said Friday.

In a dispatch from her detention cell inside Camp Crame in Quezon City, De Lima said Gordon should answer the “allegations of impropriety” against him “for the sake of the Senate and the [PRC].”

“The allegations, prima facie, are serious enough to warrant a separate full-blown investigation on the precise nature of the transaction between PRC and PhilHealth,” De Lima said.

“The badges of irregularities are undeniable,” she claimed.

Resigned PhilHealth anti-fraud officer Thorsson Montes Keith was quoted in earlier reports as claiming that Gordon, as PRC chair, could be liable for the allegedly questionable deal wherein the humanitarian organization received P100 million in advanced payment from PhilHealth for the conduct of COVID-19 tests.

Before this, the Inquirer had already reported that PhilHealth auditors said the award of P100 million in “mobilization” funds to PRC could have violated the Universal Healthcare (UHC) law and the Red Cross charter.

READ: 2 execs tied to PhilHealth ‘cash-slapping bonanza’

“[PRC’s] charter only allows them to recover the cost for services rendered, which they have not yet rendered in this case,” the government auditors said.

“However, this can be overlooked due to the very gallant act of [PRC] of taking cognizance of the PCR testing due to the swift accreditation of their laboratories when even some DOH hospitals have not been accredited until now,” they noted.

In the same Inquirer report, Gordon denied that the agreement between PRC and PhilHealth runs counter with the organization’s own charter.

Further, the PRC chair had said that PhilHealth already owed the humanitarian organization millions of pesos as the state insurer had not been supposedly reimbursing it for the cost of the COVID-19 tests it had conducted.

‘Clear conflict of interest’

De Lima, in her statement, said the agreement between PRC and PhilHealth raises a “clear conflict of interest” since Gordon chairs the Senate blue ribbon committee, which earlier embarked in an investigation into PhilHealth.

De Lima also pointed out that PhilHealth, as a government-owned and controlled corporation, “could not agree to advance payments as it is contrary to our laws.”

“Yet, it was included in the MOA (memorandum of agreement). In fact, [P100 million] was paid upfront upon execution of the MOA,” she noted.

She also cited the Bayanihan to Heal as One Act,  which she said did not repeal or suspend the provisions of the state auditing code that prohibits payment of advances without prior approval of the President.

“It cannot be argued that the basis for the advance payment agreement is the Interim Reimbursement Mechanism (IRM). Under PhilHealth Circular 2020-0007, the IRM is limited to Health Care Institutions (HCIs) directly hit by fortuitous events with clear and apparent intent to continuously operate and/or rebuild,” De Lima said.

“The PRC does not fall under this qualification. The apparent intent is for the MOA to be an agreement different from the IRM agreements under PhilHealth Circular 2020-0007. The MOA itself provides for a ‘prospective payment mechanism.’ What then is the statutory basis for agreeing to advance payments?” she added.

She said an investigation should be conducted to determine if the “questionable” provisions under the MOA between the PRC and PhilHealth “are repeated in other agreements entered into” by the state insurance firm.

“Even as many hospitals feel the pinch of having to wait for PhilHealth reimbursements for their COVID-19-related expenses, we see some institutions favored by not just prompt but advanced payments agreed to in spite of clear statutory prohibitions,” De Lima added.

“This administration’s actions on these allegations will reflect its commitment to the rule of law,” she said.

Gordon’s report

De Lima also questioned Gordon’s report, which was based on the blue ribbon committee’s 2019 investigation into alleged fraud in PhilHealth.

READ: Senate panel wants criminal raps vs ex-DOH chief Garin, other former officials

“It suspiciously left out the national leadership of PhilHealth, led by its former Chair and CEO Ricardo Morales. These PhilHealth officials are the very same officials with whom the PRC negotiated the MOA,” the lady senator said.

“Mr. Morales and his fellow officers are now facing administrative and criminal charges recommended by Task Force PhilHealth and approved by no less than Pres. Duterte,” she added.

READ: Duterte OKs filing of cases vs Morales, other execs over PhilHealth mess

INQUIRER.net has sought the comment of Gordon on De Lima’s statement but has yet to receive a response as of writing.

KGA