NBI Dagupan files raps vs hospitals, PhilHealth officials over misuse of COVID-19 advances

The National Bureau of Investigation – Dagupan District Office (NBI-DADO) filed complaints against some 20 PhilHealth officials and at least 18 hospitals in the Ilocos Region over alleged misuse of the Interim Reimbursement Mechanism (IRM).

The complaints were filed before the Office of the Ombudsman in Quezon City on Wednesday, September 1.

Among those sued was former PhilHealth President and CEO Ricardo Morale, as well as, others officers from the agency’s central office.

Rizaldy Jaymalin, NBI-DADO chief, said they filed the complaints upon orders of NBI OIC-Director Eric Distor.

Five officers from the regional office were included in the complaints filed by the NBI. These were former PhilHealth Regional Vice President Alberto Manduriao, its Chief of Healthcare Delivery Management Division, former and current Fiscal Controller Head of Fund Management Section, and Senior Social Insurance Officer.

Also included in the complaints were hospitals in Region 1 which were sued as early as July. These were:

• Balaoan District Hospital
• Blessed Family Doctors Hospital
• Caba District Hospital
• Candon St. Martin de Porres Hospital
• Corpuz Clinic and Hospital
• Dr. Bonifacia V. Albano Memorial Hospital
• Elguira General Hospital
• Gaoat General Hospital
• Gov. Roque B. Ablan Sr. Memorial Hospital
• Ilocos Sur District Hospital-Magsingal
• Jesus Nazarene General Hospital
• Judge Celestino Guerrero Memorial Hospital
• La Union Medical Center
• La Union Medical Diagnostic Center and Hospital
• Lorma Medical Center
• Mariano Marcos Memorial Hospital and Medical Center
• Nuestro Señor Santo Niño Hospital
• Pangasinan Doctors Hospital
• Pira Hospital
• Socony Medical Group
• Sta. Teresita Hospital
• Sto. Cristo Milagroso Hospital
• Sto. Niño Hospital
• Tayug Family Hospital.

Jaymalin said they filed the complaint for violation of Section 44 of the Republic Act 10606, otherwise known as the National Health Insurance Act of 2013; Technical Malversation; violation of Section 3 (e), (g), and (j) of Republic Act 3019, otherwise known as Anti-Graft and Corrupt Practices Act; and administrative cases of Grave Misconduct, Gross Dishonesty, Gross Negligence, and Conduct Prejudicial to Best Interest of Service.

The alleged offenses stemmed from the improper use of the IRM.

The IRM is the program handling emergency cash advances for medical facilities during “fortuitous events” like the ongoing pandemic. The program gave hospitals an “emergency cash buffer” for continuous delivery of medical services.

President Duterte on 2020 declared the country under state of calamity due to the COVID-19 pandemic. These qualified COVID-19-related cases to fall under the IRM.

However, Jaymalin said they found several irregularities in the PhilHealth transactions.

Some hospitals were applying the IRMs for cases that happened in 2018 and 2019, even before the country was hit by COVID-19.

“Nadiskubre naming inapply nila pondo sa pasyente 2018 and 2019, eh walang pandemic (We discovered that they were applying the funds to 2018 and 2019 patients, but that was long before the start of the pandemic),” said Jaymalin.

“Hindi ito dapat inaapply sa utang ng Philhealth ng 2019 kasi may ibang proseso para doon, yung regular claims (These should not be charged against 2019 payables of PhilHealth because there is a different process that. These are regular claims),” he added.

Jaymalin also said medical centers and hospitals must first receive letters on invitation from PhilHealth before they could issue a letter of intent to avail of the IRM.

The NBI regional chief noted that there were instances when some hospitals which did not receive invitations from PhilHealth still filed letters of intent to avail the IRM.

“May inside info na irerelease na pondo. Hindi ka pa iniimbitahan, nauuna ka nang magsabi na gusto mo yon (They had inside information that the fund would be released. You were not invited, but you still asked the agency for funds) , ” he said.

Meanwhile, PhilHealth Region I said in a statement that it respected the country’s justice system and that it would answer and explain its side at the Office of the Ombudsman. – Rappler.com

Ahikam Pasion is a Luzon-based journalist and an awardee of the Aries Rufo Journalism Fellowship.