Some hospitals upcasing non-coronavirus cases, says PhilHealth

MANILA, Philippines — The Philippine Health Insurance Corporation (PhilHealth) said it received several reports that some hospitals are misreporting non-coronavirus cases as such, supposedly in a bid to claim higher reimbursement from the state insurer.

This was bared by PhilHealth president and chief executive officer Ricardo Morales Wednesday in an interview with ABS-CBN’s Teleradyo, adding his assurance that the anti-fraud system of PhilHealth will continue to monitor such cases.

“Marami tayong reports ngayon na ‘yung hindi COVID, nirereport na COVID eh. Kunwari naaksidente o na-istroke, nirereport na COVID. Marami tayong nakukuhang balita na ganyan,” he said.

(We have received several reports that non-COVID cases are being reported as cases of COVID. For example, those who have a stroke or went through accidents, they are being reported as COVID-19 patients. We receive a lot of reports like that.)

Morales said PhilHealth has not yet filed complaints against those responsible for this alleged scheme as the firm was still verifying the reports.

He said complaints will be filed against erring hospital officials but added that PhilHealth would want the hospitals to continue operating given the need for healthcare facilities during the COVID-19 pandemic.

“’Yung mga propesyunal, ‘yung mga pumipirma ng mga diagnosis, physician, ‘yung mga tao, ‘yun ang hahabulin natin,” he also said.

(The professionals, those who sign the diagnosis, the physicians, the people, we will run after them.)

Morales earlier said PhilHealth is currently investigating some 20,000 cases of alleged fraudulent transactions that involve P4.5 billion funds, as the firm is hounded by corruption allegations and faces several investigations.

The country has already recorded a total of 139,538 COVID-19 cases, with additional 2,987 cases reported on Tuesday. Of the confirmed cases, 68,794 are active cases, 68,432 are recoveries, and 2,312 have resulted in deaths.

EDV