COA: PhilHealth still has P7.86 billion unsettled disallowances

MANILA, Philippines – The Philippine Health Insurance Corporation (PhilHealth) is yet to settle disallowances amounting to P7.858 billion by the end of 2022, according to the Commission on Audit (COA). 

In its 51-page report, state auditors said that PhilHealth’s head office has the biggest incurred disallowances with P1.9 billion or 24% of the total amount, followed by Central Luzon with P610.47 million and the Cordillera Administrative Region with P304.055 million.

When a government transaction is disallowed, it is deemed irregular, excessive, or even illegal, and the funds used for it must be returned to the government.

The largest part of PhilHealth’s disallowed amounts are cash gifts, allowances, stipends, holiday and birthday packages, and bonuses that were given without prior approval or legal basis. There are also amounts that were considered unauthorized or excess payments to contractors. 

A portion of these notices of disallowances (ND) can be traced back to more than 15 years ago. This long timeline comes as PhilHealth continually appealed for COA to lift NDs, even going to the Supreme Court. 

Just last February 2023, SC affirmed the commission’s decision to disallow P15.2 million worth of unauthorized benefits paid out to PhilHealth employees in 2009 and 2010.

In this ruling, the High Court stated that “good faith is no longer a defense for recipients of subsequently disallowed public benefits or allowances.” 

While there have been several other NDs resolved, many are still under appeal with the COA Commission Proper or the SC. – Rappler.com