Metro Manila (AdChoiceTV News, June 8) — President Rodrigo Duterte upped the ante against a Quezon City dialysis center, ordering the National Bureau of Investigation to arrest its owners.
This, after the President called the Philippine Health Insurance Corporation (PhilHealth) to pursue criminal charges against its erring officials and employees.
“The estafa is continuing. It is syndicated estafa ‘yan. No bail ‘yan. Kaya arestuhin niyo [So you should arrest them] because right at this moment, the estafa, the malversation of money is continuing,” Duterte said Saturday midnight on the TV program of his close ally, Kingdom of Jesus Christ founder Apollo Quiboloy.
PhilHealth said it has filed 28 counts of administrative charges against a dialysis center in Novaliches, Quezon City after finding “strong evidence” that it has been defrauding the agency since 2016. It also charged four doctors with the facility.
But Duterte called these charges “s***.” “I tell them arrest the idiot and I will bring him to Malacañang and I will ask him, ‘Tell me the truth and I’ll throw you to the river.’ But he will be extricated, we’ll not allow him to be drowned,” he said.
He said that NBI agents must “take over” the dialysis center by tomorrow, arrest its owners and investigate them.
PhilHealth reshuffle
While saying that he has not yet found any evidence that PhilHealth officials had a hand in the alleged fraud, Duterte is still eyeing to reorganize the state insurance fund to “install more systems of accounting and accountability.”
“I have to reorganize your entity, change, maybe all of you and ... Bakit umabot nang ganung kalaki [Why did it reach that amount] without the necessary checks along the way?” he said.
He added that he is still investigating if anyone in the state insurance fund was in cahoots with the dialysis center’s alleged fraudulent schemes.
Lawyer Harry Roque, who serves as counsel to the two whistleblowers on the alleged anomalies in PhilHealth, told AdChoiceTV News that all officials of the state insurance fund will be slapped with charges over the supposedly fraudulent benefit claims for nonexistent kidney treatments.
Rodolfo del Rosario, PhilHealth senior vice president for legal sector, said the dialysis center claims all free 90 dialysis sessions annually even if the patient has already died by faking their signatures, confirming the claims of the whistleblowers.
PhilHealth Acting President Roy Ferrer said there may be a “mafia” in the state insurance fund targeting him because of his focus against fraud.
Ferrer said 38 employees, some middle managers, have been suspended for various offenses. He said he has asked the help of the Civil Service Commission to reassign erring PhilHealth officials.
'No overpayment'
The Philippine Daily Inquirer was first to report the fraud allegations against the Quezon City dialysis center. It has since released a follow up to the story, where it detailed how PhilHealth lost ₱145 billion to overpayments and fraud.
However, the PhilHealth denied this in a statement, saying the problem lies in "upcasing" or the practice of some medical professionals to declare minor illnesses as something more serious so they can cash in on higher reimbursements.
PhilHealth said that it is probing 1,251 cases of reported pneumonia cases from 162 providers for potential fraud. It added that it has completed close to 1,500 investigations and is still probing 9,000 more reports of fraudulent activities.
"It must be remembered that there is no health insurance system in the entire world that is fraud-free,” Ferrer said in the statement.
This is not the first time that allegations of fraud in the state insurance fund surfaced.
Senate President Vicente "Tito" Sotto III has previously brought up claims of insurance fraud during last year's budget deliberations, saying he has received reports that a neurologist in South Cotabato recruits PhilHealth members to pretend to be sick in exchange for ₱1,000.
Sotto also questioned why pneumonia topped the claims to PhilHealth from January to June 2018 when no outbreak has been declared.
"Currently, they (PhilHealth) are investigating because there are a number of cases that are upcasing. So, simple case of colds, cough and bronchitis, they are claiming them as pneumonia or even severe pneumonia," said Senator Joseph Victor "JV" Ejercito during the budget deliberations. - AdChoiceTV News
AdChoiceTV News, Robi Chan contributed to this report
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