Pangasinan execs hit health fraud allegation

BAGUIO CITY—The mayors of a town and a city in Pangasinan are taking offense at accusations made by a health official alleging that local governments are conniving in an eye care fraud that is draining the coffers of the Philippine Health Insurance Corp. (PhilHealth).

In separate statements, Urdaneta City Mayor Amadeo Gregorio Perez IV and Villasis town Mayor Libradita Abrenica protested allegations made at the Senate on July 8 by Dr. Minguita Padilla, chair of the Eye Bank Foundation of the Phils., that local officials are among the suspected “sweepers” who entice patients to seek medical care from private hospitals in exchange for kickbacks.

Perez said Padilla’s statement “puts all of us local government officials under a cloud of doubt… [by] confusing referrals with recruitment.”

“Dr. Padilla ought to know that mayors and other local officials make hundreds of referrals every week in response to the needs of our constituents,” said Diaz.

Abrenica also issued a certification saying that the municipality never received any commission from Sacred Heart Hospital, a private facility in Villasis, for referring eye patients.

At the Senate hearing, Padilla said local government officials usually send “sponsored patients enrolled with government funds” to private hospitals which she claims earn millions of pesos and pay kickbacks to local officials.

Padilla said she wants local governments to refer patients instead to government hospitals which can benefit from income from cataract surgeries.

Mayor Perez said Padilla is unrealistic because “I’m sure she knows about the sad state of our government health facilities, including our hospitals.”

“Even if we want to refer our constituents to government hospitals, the truth is not all our government hospitals can handle cataract surgeries, and so we have no choice but to refer our patients to private facilities,” said Perez.

“And for this Dr. Padilla is accusing us of taking kickbacks,” the mayor said. “With her line of thinking, it is no wonder that our government health system is in shambles,” the mayor added.

A newly appointed director of PhilHealth, defeated senatorial candidate Risa Hontiveros of the civil society group Akbayan, said the state health insurance firm has improved its tracking system to detect scams.

“Since November, we have been auditing some medical and surgical procedures where reimbursement claims rose dramatically for possible red flags,” Hontiveros said in a press conference here last week.

PhilHealth also discovered cases where doctors violated their commitments to quality health care, abused patient’s rights and committed fraud, Hontiveros said. Vincent Cabreza, Inquirer Northern Luzon