MANILA, Philippines — Ombudsman Samuel Martires suspended for six months without pay eight senior officials of Philippine Health Insurance Corp. (PhilHealth) who are facing administrative and criminal complaints in connection with the alleged irregular release of P2.7 billion from the insurer’s interim reimbursement mechanism (IRM).
The officials were identified as Arnel de Jesus, chief operating officer; Renato Limsiaco and Israel Francis Pargas, senior vice presidents; Gregorio Rulloda, vice president for National Capital Region (NCR); Lolita Tuliao, NCR central branch manager; and Imelda Trinidad de Vera-Pe, Gemma Sibucao and Lailani Padua, executives.
NBI charges
“After a thorough consideration of the records, this office finds sufficient cause to place respondents under preventive suspension…,” the Ombudsman’s seven-page order said.
Earlier, the National Bureau of Investigation filed charges of grave misconduct, gross neglect of duty and conduct prejudicial to the best interest of the service against the eight officials and former PhilHealth president Ricardo Morales. The charges stemmed from the release of IRM funds through cash advances to 139 health-care institutions (HCIs) in Metro Manila.
Morales resigned in August due to health reasons.
According to the bureau, the IRM funds appropriated for COVID-19 response were instead given to predetermined health-care institutions, including many that did not treat COVID-19 patients.
The disbursement of the cash advance also did not comply with procedures set by the Commission on Audit.
Official documents
The NBI had asked for the preventive suspension of the officials.
Under the Ombudsman Act of 1989 and its Rules and Procedure, the Ombudsman or his deputy can impose a preventive suspension of officials under investigation if the evidence of guilt is strong and their continued stay in office would influence the case filed against them.
“Respondents facilitated these anomalies by affixing their signatures on official documents causing the release of the questioned IRM funds. These documents include the document review and assessment request recommending the approval of fund requests of HCIs, memoranda of agreement with HCIs and disbursement vouchers, among other things,” Martires said.
He said that “since the respondents’ respective positions allow them to wield influence on possible witnesses and to access public records, their continued stay in office may not only prejudice the cases against them but allow them to commit further acts of malfeasance.”
Martires directed PhilHealth President and CEO Dante Gierran to implement the suspension order.
House panel’s findings
“This consolidated order is immediately executory and shall not be interrupted within the period prescribed notwithstanding any motion, appeal or petition that may be filed by respondents seeking relief from this consolidated order, unless otherwise ordered by this office or by any court of competent jurisdiction,” the Ombudsman said.
The suspension order came a day after a joint panel of the House of Representatives recommended the filing of administrative and criminal charges against Health Secretary Francisco Duque III, PhilHealth chair, and other officials of the state insurer.
The 80-page report of the committees on public accounts and on good government and public accountability included findings on the IRM, the implementation of the all-case rate, PhilHealth’s operation of an unauthorized payment system, the disadvantageous settlement of cases, fraudulent claims, adverse audit reports and other alleged irregularities.
It will be submitted to the Department of Justice for further study.
The Senate committee of the whole earlier recommended the filing of graft and malversation cases against Duque, Morales and other senior executives for the release of IRM funds to health facilities that did not treat COVID-19 patients.
As chair of the PhilHealth board, Duque was held liable for the “flawed” mechanism of the IRM amid reports of preferential treatment for certain private HCIs.
The health chief decried the charges as an “injustice,” saying he was not a signatory to the resolution that paved way for the IRM in March as he was then occupied as chair of the Inter-Agency Task Force for the Management of Emerging Infectious Diseases, the temporary body in charge of the government’s response to the pandemic.