PhilHealth

Plunder case eyed vs former PhilHealth exec over 2011 settlement with Cardinal Santos hospital

Mara Cepeda
Plunder case eyed vs former PhilHealth exec over 2011 settlement with Cardinal Santos hospital

Congress on more alleged illegal practices in PhilHealth. Photo from House of Representatives

(3rd UPDATE) Lawmakers also want charges filed against the former owner and manager of Cardinal Santos Medical Center – the Roman Catholic Archdiocese of Manila and Hospital Managers Inc, respectively
Plunder case eyed vs former PhilHealth exec over 2011 settlement with Cardinal Santos hospital

Lawmakers believe a former official of the Philippine Health Insurance Corporation (PhilHealth) and the former executives of Cardinal Santos Medical Center could be held liable for plunder over a settlement case in 2011. 

As the House continued on Tuesday, August 25, its probe into the corruption allegations faced by PhilHealth, Deputy Speaker Rodante Marcoleta zeroed in on the 2011 case involving the state health insurer and the the owner of the land where the San Juan City-based hospital is located, Roman Catholic Archdiocese of Manila (RCAM),  and its former manager, the Hospital Managers Incorporated (HMI).

At the time, PhilHealth’s senior vice president for the legal sector was Edgar Asuncion.

Lawmakers and PhilHealth officials initially identified RCAM as a former owner of Cardinal Santos during the hearing. But RCAM administrator Bishop Broderick Pabillo issued a statement on Wednesday, August 26, saying that while RCAM does own the property where the hospital is erected, it is not involved in Cardinal Santos’ day-to-day operations and “was not involved in any transactions with PhilHealth.”

Pabillo said they had engaged the services of HMI to manage Cardinal Santos from August 1988 to July 2008.

Even if Cardinal Santos had owed PhilHealth P240 million in overpayments of insurance claims, the agency’s legal team under Asuncion agreed with HMI’s offer to just pay P70 million.

In effect, PhilHealth lost P170 million in the settlement case.

Cardinal Santos’ scheme then was to first claim from PhilHealth the complete fee-per-service payment – or the equivalent of the total medical expenses incurred by the patient – but it would only charge the PhilHealth member concerned P3,000. 

The hospital would then keep the remaining funds for itself, accounting for P240 million in overpayments from PhilHealth. 

“Madaling sukatin ito eh. The processes taken by PhilHealth is very suggestive of corruption. Papaano po mali-legal?…. Papaano ’nyo pangangatuwiranan na okay na ’yong P170 million [na nawala]?” asked Marcoleta. 

(This is easy enough to measure. The processes taken by PhilHelath is very suggestive of corruption…. How can you say this was legal? …. How can you explain that it’s okay that you lost P170 million?)

Marcoleta also slammed PhilHealth for settling when the money involved belonged to PhilHealth members, not the agency.

“Papaano ‘nyo i-account na balanse na P170 million? Sabi nga po namin, kahit isang sentimo, ‘pag mawala sa pondo ng gobyerno, hahanapin po ‘yon sapagkat pera ng tao po ‘yon,” he said.

(How would you account for the balance of P170 milion? We have long been saying that we would always look even for a missing cent in the government’s coffers because that is the money of the people.)

Marcoleta, however, could not ask questions directly to Asuncion. The House committees conducting the joint investigation had been wanting to invite Asuncion to the hearings, but nobody seemed to know where and how to contact him.

House committee on public accounts chair Mike Defensor then said the former PhillHealth executive could be charged with plunder since the agency lost P170 million under his watch.

Cavite 7th District Representative Jesus Crispin Remulla agreed and moved to ask law enforcement agencies to hunt down Asuncion.  He also wants the National Bureau of Investigation (NBI) to study filing plunder charges against Asuncion.

“Mr Chairman, I believe that we have to send the law enforcement agencies against Attorney Asuncion and we can direct the NBI to study the filing of plunder charges because, in this case, the investigation will need law enforcement people to locate Mr Asuncion if he does not want to appear before this body or if he is guilty of any [issues],” Remulla said.

“He who does not appear before a body like this would seem to be guilty, Mr Chairman,” he added.

Defensor modified the motion and instead gave Asuncion until the next hearing on Thursday, August 27, to show up and respond to lawmakers’ questions. 

Otherwise, Asuncion would be held in contempt and legislators would also recommend the filing of plunder charges not just against him but also HMI and RCAM.

“If no clarification is given [to] us by the honorable Asuncion by Thursday, the next hearing, this committee will recommend the filing of plunder charges based on the documents submitted to us by PhilHealth arbitration and Philhealth legal,” Defensor said.

“[This committee will also] recommend to file a case against Attorney Edgar Asuncion, the Hospital Managers Inc, and the Roman Catholic Archdiocese of Manila. So moved,” he added.

Asuncion finally showed up before lawmakers on Thursday. He explained it was the court that set the settlement amount at P70 million following judicial accounting in the case.

“All I was saying, after the court has appreciated all the evidence, the court found out that it was just P70 million. That was the purpose of the judicial accounting because there was a big difference between [what] PhilHealth was saying and what HMI was saying,” Asuncion said.

Lawmakers, however, were not satisfied with his answer.

Nasaan ngayon ang protective ability ninyo na alagaan, proteksiyunan ang pondo ng PhilHealth? Sinurrender ninyo ang P170 million so easily dahil pinadaan mo sa korte,” Marcoleta said.

(Where is your protective ability to protect the funds of PhilHealth? You surrendered the P170 million so easily because you let it pass through the court.)

Barzaga then moved for the House panels to ask the NBI to study the filing of plunder charges against Asuncion. The committees approved the motion without any objections.

The 2011 PhilHealth-Cardinal Santos Medical Center settlement case is just the latest in a string of anomalies uncovered in the ongoing House probe into the state health insurer.

During Tuesday’s hearing, a commissioner from the Civil Service Commission told lawmakers that Chairperson Alicia dela Rosa Bala allegedly ordered them to stay silent on the details of pending administrative cases filed against PhilHealth officials

Bala, however, denied making such an order. – Rappler.com

Mara Cepeda

Mara Cepeda specializes in stories about politics and local governance. She covers the Office of the Vice President, the Senate, and the Philippine opposition. She is a 2021 fellow of the Asia Journalism Fellowship and the Reham al-Farra Memorial Journalism Fellowship of the UN. Got tips? Email her at mara.cepeda@rappler.com or tweet @maracepeda.