Hontiveros to file bill that will protect PhilHealth from fraud

MANILA, Philippines — Opposition Senator Risa Hontiveros is set to file a bill to shield the Philippine Health Insurance Corp. (PhilHealth) from fraudulent activities such as false claims and overpayments.

Hontiveros said Wednesday she is planning to file the bill, which will be titled PhilHealth Insurance False Claims Act, to prevent and minimize fraud in spite of the penalties under the Universal Health Care Act.

She added that Senator Panfilo Lacson’s recent exposé on fraudulent activities in PhilHealth also calls for a review of the agency’s anti-fraud mechanisms.

“Every peso lost to corruption in our health programs would mean that a citizen is deprived of potentially life-saving medication or treatment. Corruption makes our people unhealthy and even threatens their lives,” Hontiveros said in a statement.

Among the senator’s proposals to improve PhilHealth’s anti-fraud mechanisms is a shift from the current payment to a diagnosis-related grouping provider payment mechanism as well as giving support to the agency’s staff who report anomalies.

She also said that the penalty of suspending hospital operations should be revisited and imposing monetary penalties at least three times the amount of the detected fraud should be considered.

Hontiveros said she was particularly alarmed over the report that PhilHealth continues to overpay fraudulent hospitals and clinics through “overstaying” or “ghost patients.”

“Mukhang tuloy-tuloy ang mga anomalya mula sa hakot operation ng mga eye clinics, ghost dialysis patients hanggang sa mga kontrobersyal na repayments. Hindi maaari ito,” she said.

“Defrauding the government and depriving countless Filipinos of access to health services is an unacceptable and criminal misuse of public money,” she added.  /muf