Health official doubts 'ghost dialysis' whistleblowers masterminded scam

ABS-CBN News

Posted at Jun 07 2019 08:07 PM

MANILA - Whistleblowers of the "ghost dialysis" scam could not have masterminded the filing of fraudulent insurance claims made by a dialysis center in Quezon City, a Health official said Friday.

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WellMed Dialysis Center earlier said the company would be filing charges against 2 employees who allegedly connived in filing insurance claims for dead patients between 2016 and 2018.

The said workers were the same people who reported the scam to the Philippine Health Insurance Corporation (Philhealth) last year, and relayed the scheme to broadsheet Philippine Daily Inquirer earlier this week.

"I don't think there would be motivation for them to file fraudulent cases," Health spokesperson Dr. Rolando Enrique "Eric" Domingo told ANC's Early Edition.

"If they were nurses and they file the claims, the money would not go to them, it will go to the hospital," he said.

"Every time Philhealth reimburses, it goes directly to the hospital," he said.

Domingo noted that the scheme could not be perpetrated by two employees alone as claim forms would also have to be signed by doctors in the accredited clinic.

"If the doctor knows that the patient is dead but is still claiming services then that is really fraud," he said.

Philhealth said it had stopped disbursing payments to WellMed Dialysis Center while investigations are ongoing, but its accreditation has yet to be suspended.