3 PhilHealth execs testify before govt task force probing alleged anomalies


Posted at Aug 20 2020 03:35 PM

MANILA - Three PhilHealth officials testified before the government's task force investigating alleged corruption in the state insurance firm, the Department of Justice said Thursday.

The following officials gave their statement Wednesday, according to DOJ Undersecretary Markk Perete:

  •  Senior Vice President and Chief Information Officer Jovita Aragona
  •  Corporate Secretary Jonathan Mangaoang
  •  Ernesto Barbado, acting senior manager of PhilHealth's Fact-Finding Investigation and Enforcement Division

Mangaoang said PhilHealth's board members approved the proposal of the firm's Protest and Appeals Department to grant amnesty to hospitals that filed claims for reimbursement from 2011 onwards, Perete said in a statement.

"The law that created PhilHealth renders ineligible for reimbursement a claim filed beyond 60 days from the discharge of a patient," he said.

Senators earlier questioned PhilHealth's release of COVID-19 funds to other medical facilities such as dialysis and maternity care centers while some hospitals with virus patients have yet to receive their reimbursement claims.

The Davao City-based Southern Philippines Medical Center topped the list of hospitals that received interim reimbursement mechanism (IRM) funds with P326 million despite the region having only 1,572 COVID-19 cases. The region's PhilHealth office and an SPMC official said it was based on the hospital's 90 days annual historical benefit claim and noted that SPMC caters to the whole Mindanao.

The agency's IRM was proposed in January to ensure hospitals and medical facilities were financially viable in case of emergencies, Mangaoang told the task force. 

PhilHealth president and CEO Ricardo Morales earlier told senators the IRM was in preparation for the COVID-9 pandemic.

The state insurance firm and the Department of Health, however, said the IRM was based on past figures, instead of the current need of hospitals.

The PhilHealth Board approved the IRM based on the opinion of the corporation’s legal sector, Mangaoang told DOJ.

Aragona, meantime, admitted to the inability of PhilHealth's IT systems to detect fraudulent claims and "identified the segments in the corporation’s validation processes that are still done manually," Perete said.

She also said she had called for an investigation into the reported questionable procurement of switches by PhilHealth's Metro Manila Office, Perete added.

Barbado asked the task force to investigate "certain ghost or fake claims" his office had previously looked into, the DOJ said.

The task force had ordered composite teams to conduct further interviews and audits, gather evidence, and report their findings prior to taking the testimony of PhilHealth officials, Perete said.

The Senate on Wednesday said it would end its investigation into PhilHealth anomalies and urged the Office of the President to suspend its officials as they face probe. 

The President's anti-corruption body also launched an investigation and said it would file criminal and administrative complaints against several officials of PhilHealth.

Six PhilHealth regional vice presidents earlier took their leaves of absence to give way to investigations.

The DOJ-led task force has 30 days from the time of its constitution on Aug. 14, to submit recommendations to the Office of the President.