The National Bureau of Investigation – Central Visayas (NBI-7) filed a complaint on Tuesday, February 9, against the Philippine Health Insurance Corporation and Chong Hua Hospital here for fraudulent transactions involving a “fake” COVID-19 patient.

The complaints were filed with the Office of the Ombudsman against the two parties for their alleged malversation of public funds through the falsification of public documents and violating RA No. 3019 or the Anti-Graft and Practices Act.

NBI-7 Executive Officer Arnel Pura said that there was an irregular facilitation of funds involving patient Kim Solamo, who allegedly claimed a full benefit package from PhilHealth meant for frontliners positive with COVID-19.

“During our investigation, it was established that Kim Solamo is unemployed. He is not a health worker, he was not a frontliner, and despite that evidence or certification, the claim was approved,” said Pura.

“He should not be entitled to such a claim,” he added.

NBI-7 Regional Director Renan Oliva said the irregularity was verified through certifications from the Social Security System, Bureau of Internal Revenue, and the local government of Carmen town, where Solamo resided.

The NBI said Solamo has been jobless for a decade and suffered kidney and liver diseases. He was also never a frontliner but was a former delivery man.

The investigation showed that Chong Hua Hospital (CHH) filed for a COVID-19 claim amounting to P193,000.

Ten PhilHealth officials and 3 officers of CHH were named in the complaint.

Chong Hua Hospital denies allegation

“In light of allegations being leveled against our institution, Chong Hua Hospital categorically denies any mishandling of the PhilHealth benefits of our patients,” said CHH on its social media.

“Our claims filing and reimbursement procedures for the implementation of COVID-19 benefits for in-patient care (for both probable and/or confirmed cases) are fully compliant with all PhilHealth circulars and guidelines,” they added.

In a post by local media outlet CDN Digital, PhilHealth said that its officers and employees abide by the guidelines set for the processing of claim documents and that it would answer the charges in the proper forum

A number of scams, corruption cases, fraudulent activities have already been recorded and filed against PhilHealth since 2020.

The House of Representatives recently passed two bills that called for the suspension of increases in insurance payments during the pandemic.

In October 2020, PhilHealth-7 officials and officers from Perpetual Succour Hospital Incorporated (PSHI) were also involved in a fraudulent COVID-19 claims. –With reports from Ryan Macasero/ Rappler.com