PhilHealth official cites 'capacity issues' for failure to file 992 fraud cases

Katrina Domingo, ABS-CBN News

Posted at Aug 18 2020 07:26 PM

MANILA - The Philippine Health Insurance Corp (PhilHealth) failed to file some 900 cases against erring individuals and hospitals due to "administrative capacity issues," the head of the agency's legal department said Tuesday.

Only 11 of 1,003 cases have been filed before courts as the agency needs some 138 more officials to "strengthen the enforcement mechanism" of PhilHealth regional offices, Senior Vice President for Legal Sector Rodolfo del Rosario said during the Senate Committee of the Whole's investigation into alleged irregularities in the state-run insurance firm.

"Ang problema po natin, ang pag-file ng criminal complaints, which is a function of our regional offices," Del Rosario told senators.

(Our problem is the filing of criminal complaints is a function of our regional offices.)

"We are recommending the revision of these provisions... para mapabilis na din (so we can speed it up)," he said.

Senate Majority Leader Juan Miguel Zubiri noted that the PhilHealth's legal department has been charging fines for erring hospitals, and have downgraded some criminal cases into administrative charges.

"Cases were brought down to mere administrative cases rather than criminal cases... Their hands were caught inside the cookie jar, huling huli talaga sila, but no cases were filed against them," Zubiri said.

The Senate Majority leader nearly cursed after Del Rosario confirmed that hospitals with pending cases continued to receive funds under the PhilHealth's interim reimbursement mechanism.

"Biro mo, nahuli nang nagnanakaw yung magnanakaw, hindi niyo pa din nilalagay sa kulungan? Patuloy niyo pa din nilalagyan ng pondo ang mga lugar na ito para mapagnakawan?" the senator said.

(Imagine, they were already caught stealing, and you did not just fail to jail them, you also continued to give funds to these places where they can steal it.)

"Mapapamura ka ng 'p***a'. P*****g i**, magagalit ka talaga," he said.

(You will really curse about this. It really makes you mad.)

The Governance Commission for GOCCs has "recently approved 12 plantilla positions for lawyers" for the insurance firm, said Health Secretary Francisco Duque III, who chairs the PhilHealth board.

PhilHealth whistleblowers earlier accused Del Rosario of being part of an alleged syndicate inside PhilHealth.

Del Rosario deliberately stalls the filing of cases against fraudulent claims to protect his cohorts, resigned PhilHealth anti-fraud officer Thorrsson Keith said in previous hearings.

Del Rosario denied the allegations and said he would file libel charges against Keith for the "baseless" accusations.