Gov’t task force also uncovers alleged rampant corruption in PhilHealth

JC Gotinga
A composite task force under the Executive hears allegations of massive fraud involving the state insurer's main and regional offices

A task force composed of several agencies of the Executive has begun its probe into alleged rampant corruption in the Philippine Health Insurance Corporation, where two resource persons exposed fraudulent schemes that parallel allegations made at ongoing congressional probes.

Task Force PhilHealth also heard allegations of “abuses and flaws” in PhilHealth’s legal and Information technology departments, the Department of Justice (DOJ) said in a statement on Saturday, August 15, a day after it led the task force’s first investigative hearing on the controversy.

In Friday’s hearing, the task force had “two individuals formerly connected with PhilHealth” as resource persons. They requested anonymity, the DOJ said.

The resource persons spoke of “different fraudulent schemes allegedly employed through the years by PhilHealth officers and employees, both at its main office and regional offices, in collusion with some doctors and hospitals, and even banks which act as remittance centers,” the DOJ said.

“These schemes include the payment of false or fraudulent claims against the corporation, malversation of premiums, and the exploitation by some unscrupulous personalities of the case rate system and the Interim Reimbursement Mechanism (IRM), among others,” the DOJ added.

“The resources persons likewise highlighted abuses and flaws in the corporation’s Legal Department and Information Technology (IT) office that allegedly made the proliferation of these schemes possible,” the DOJ said.

The DOJ did not give details of these allegations.

These findings are similar with allegations presented during earlier investigative hearings by the Senate and the House of Representatives.

The Senate, which held lengthier hearings on the PhilHealth controversy, has uncovered the following major allegations:

  • Disparities and “favoritism” in the release of IRM funds worth billions of pesos
  • The bloating of PhilHealth’s P2.1 billion IT budget by about P734 million
  • Overpriced procurement of IT equipment, such as network switches worth P320,000 apiece, priced at P62,000 in the market
  • Diversion of more than P9 million in PhilHealth funds to a Bataan-based rural bank account whose ownership is unclear
  • The PhilHealth Legal Department not taking action on some corruption cases
  • Minor illnesses like common cough or cold registered as pneumonia in order to make an insurance claim

PhilHealth’s top executives including its president and CEO Ricardo Morales have come under question from lawmakers because of these allegations.

Health Secretary Francisco Duque III, PhilHealth’s ex-officio chairperson, has been strongly criticized for his silence on the controversy. He is expected to attend the Senate’s third legislative hearing on Tuesday, August 18.

On Thursday, August 13, PhilHealth suspended the IRM, following calls from lawmakers who said the advanced benefit payment scheme was prone to corruption.

The task force investigating PhilHealth said it would conduct its hearings as a whole even as the agencies comprising it continue their own investigations and audits of the state insurer.

Led by the DOJ, the task force consists of the Office of the Ombudsman, the Commission on Audit, the Civil Service Commission, the Presidential Anti-Corruption Commission, the Office of the Special Assistant to the President, the Anti-Money Laundering Council, the National Bureau of Investigation, and the National Prosecution Service.

Any action by these individual agencies involving PhilHealth will be coordinated with the task force.

If there will be prosecutions of PhilHealth officers, employees, and other suspects, they will be “made through the task force and with the endorsement of Justice Secretary Menardo Guevarra,” the DOJ said.

The agencies of the task force shared the results of their current investigations with one another, the DOJ said. They agreed to “harmonize efforts in the lifestyle checks,” both current and pending, the DOJ added. –

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JC Gotinga

JC Gotinga often reports about the West Philippine Sea, the communist insurgency, and terrorism as he covers national defense and security for Rappler. He enjoys telling stories about his hometown, Pasig City. JC has worked with Al Jazeera, CNN Philippines, News5, and CBN Asia.