NBI probes PhilHealth execs, other institutions over 'ghost' claims

Mike Navallo, ABS-CBN News

Posted at Jun 13 2019 06:22 PM

MANILA – The National Bureau of Investigation is now probing PhilHealth officials and other medical institutions who might be involved in making “ghost claims” with the agency.

Top NBI officials disclosed this Thursday in a press conference where they presented businessman Dr. Bryan Sy, co-owner of WellMed Dialysis Center, and whistleblowers Edwin Roberto and Liezel Aileen De Leon.

Roberto and De Leon accused Sy of ordering them to lodge false claims for payment from PhilHealth on behalf of dead dialysis patients.

The three were arrested during NBI’s probe Monday.

The NBI filed estafa and falsification of documents complaints against the three with the DOJ Tuesday.

“We have a very good case. We will continue to file cases as we uncover the other anomalies,” NBI Spokesperson and deputy director for investigation service Atty. Ferdinand Lavin told the media.

“The other clinics and persons and officers of PhilHealth whom the agents will later on find equally liable and responsible will also be charged,” he added.

Harry Roque, the lawyer for the whistleblowers, criticized the NBI Tuesday for excluding PhilHealth officials from the complaints.

Former Health Secretary Janette Garin on Wednesday accused legal, finance and human resources officers of PhilHealth of being involved in fraudulent payments, without naming individuals.

But Lavin said they will look into Garin’s allegations once they receive documents.

He added that they are widening the scope of their probe and their sources include PhilHealth officials themselves, whistleblowers and patients.

“As a matter of fact, practically all the entities claiming refunds or reimbursements from PhilHealth in respect of the different claims are being watched by the NBI and PhilHealth jointly,” he said.

NBI Deputy Director for Investigative Service Vicente De Guzman III said these medical entities include hospitals and clinics accredited by PhilHealth.

They are also looking into other treatments such as treatment for cataracts, pneumonia, and other illnesses.

“We are not singling out WellMed,” De Guzman said.

“Hinihimay naming mabuti yung participation saka yung kanilang criminal negligence kung meron,” Lavin added.