Philhealth removes WellMed accreditation amid 'ghost claims' scandal


Posted at Jun 18 2019 01:54 PM | Updated as of Jun 18 2019 04:01 PM

MANILA - The Philippine Health Insurance Corporation on Tuesday withdrew the accreditation of the dialysis center tagged in the filing of insurance claims for dead patients.

"PhilHealth withdraws WellMed Dialysis Center’s accreditation today, June 18, 2019 in view of fraudulent claims filed on behalf of deceased patients," the state health insurance firm said in a statement.

"Wellmed patients are advised to transfer to other accredited dialysis facilities to ensure continuous availment of PhilHealth benefits," the agency said.

Last year, 2 former employees of the clinic reported to authorities that the dialysis center has been forging signatures between 2016 and 2018 to file claims for patients who have long been dead.

But the scandal gained national attention only earlier this month, after the whistleblowers told the details of the scam in an interview with the Philippine Daily Inquirer.

Hours before the cancellation of WellMed's accreditation, Health Secretary Francisco Duque III slammed PhilHealth officials for not immediately revoking the clinic's accreditation.

PhilHealth-Metro Manila as early as February 2019 urged the corporation's central office to stop payments for WellMed, but its accreditation committee told the regional office to submit more evidence, Duque told DZMM's Failon Ngayon.

"Why do you do that? Hindi naman ito (these are not) criminal proceedings. This is just an administrative proceeding. You do not have to demand proof beyond reasonable doubt, you only need substantial evidence," said Duque who also sits as PhilHealth's ex-officio chair.

Days before the revocation of WellMed's accreditation, authorities arrested one of the clinic's co-owners for his alleged involvement in the fraudulent scheme.

WellMed officials denied the allegations and said that it was the whistleblowers who conspired to carry out the illegal scheme.