Former patients defend Butuan Doctors Hospital in PhilHealth’s ‘fraud’ case

BUTUAN CITY—Some residents here came to the defense of the Butuan Doctors Hospital and College (BDHC), as the hospital faced charges of fraud before the Philippine Health Insurance Corporation (PhilHealth) arbitration office in Pasig City for allegedly treating non-existing patients.

Edwin Elacion, a retired police officer, told the Inquirer in a phone interview, he was treated at the Butuan facility’s Advanced Wound Care Center (AWCC) for his broken legs due to motorcycle accident in June 2018. He said he was an outpatient and had frequented BDHC for over a month for wound dressing and finally, for the putting of stainless steel implants for his bone surgery.

Elacion, 62, a former police inspector, recalled it was the first time in his 35 years of service as a police officer that he availed of PhilHealth.

He also said some PhilHealth workers had come to him not to confirm whether or not he was really treated at the hospital but rather to ask him if Dr. Jerome Asuncion, head of BDHC’s AWCC, had overpriced his billing.

“Dr. Asuncion treated me well and even prescribed imported medicines to make sure I will be totally cured,” he said.

Another PhilHealth patient, Fernando Pala, 55, a former city hall worker treated for broken joints after an accident in 2018, also said that Asuncion recommended that he would just be treated as an outpatient, if only to save huge amount of money which he needed for his two surgical operations including the putting up of a stainless steel cast on his fractured bone.

Mariaden Ligotan, whose son Nissan was admitted at the BDHC for four months and two weeks in 2017 after both of the bones of his legs were crushed by a fallen tree, said his son’s Philhealth membership helped defray a huge part of the cost as their bills reached more than P500,000.

Dr. Asuncion also advised her to have Nissan treated as an outpatient to lessen her expenses as he underwent a major surgical operation of which his left leg was cut and his right leg placed with stainless steel.

“He is a good man and understands the situation of poor patients,” Ligotan said of Asuncion.

PhilHealth Arbitration Office in Pasig City has charged BDHC with a consolidated case of 29 counts of claims for non-admitted or non-treated patients and for breach of warranties and accreditation.

PhilHealth also mentioned performance commitment under sections 151 and 160 of the 2013 Revised Implementing Rules and Regulations of Republic Act (RA) 7875, which enacted the PhilHealth program as amended by RA 9241 and RA 10606.

The amended RA 9241 already provides universal health insurance coverage and ensures affordable, acceptable, available and accessible health care services for all citizens of the country while RA 10606 mandated PhilHealth to provide health insurance coverage to all Filipinos.

BDHC and its extension AWCC, which specializes in wound care, serves patients from different parts of the region.

But PhilHealth claimed the AWCC was being rented out by Dr. Asuncion under the business name Butuan Orthopedic Clinic, a claim that BDHC lawyer Rodney Ato denied in his 25-page answer to the Philhealth Arbitration Office. Ato said the AWCC was not being rented out to Dr. Asuncion or any other third party.

JPV