PhilHealth eyes int’l firm to conduct audit
The Philippine Health Insurance Corp. is looking for an international consultancy firm to conduct a thorough audit of the agency’s account books, saying P154 billion in PhilHealth funds that are allegedly missing could not be found.
According to PhilHealth president and chief executive officer Ricardo Morales, there was no mention of such losses even in the reports of the Commission on Audit (COA).
“There are some figures being brought up, like the P154 billion. You know, COA has not found it,” he
noted in a chance interview yesterday.
Morales claimed it could be because the mandate of COA is to look into the “efficiency” of government agencies and not “corruption” so he deemed it necessary to get a third party to review the transactions of PhilHealth.
The official revealed that he is in talks with a “consulting firm with global reputation” and in three months’ time, “we may already have something to report.” He refused to name the firm until their negotiation is final.
“We need another to do an audit and I’m looking at that – to get an outside agency to do it from as far as records are available... We will have the best available and there will be no compromise,” he added.
In a privilege speech two weeks ago, Sen. Panfilo Lacson estimated that PhilHealth had incurred losses of P154 billion because of overpayments and other irregularities from 2013 to 2017.
Morales said the works of the audit team would not overlap with the investigation being conducted by the Senate on the irregularities.
“We will participate in the Senate or House (of Representatives) investigations and we will cross-reference whatever we can get from one thread to the other and back,” he added.
In a statement, PhilHealth said it “fully supports” the investigation of the joint Senate Blue Ribbon committee and the committee on health and maintained that under a new management, it has started looking into official reports and news reports on fraud.
PhilHealth added that this has resulted in 753 administrative cases filed against various health care providers and members for violation of the National Health Insurance Act of 1995 and the amending law from January to July this year.
Aside from this, 921 formal charges were lodged against various health care providers while 6,138 counts are now up for resolution of the prosecution department.
The agency gave assurance that more cases will be filed “if warranted” while plans are afoot to implement systemic reforms to prevent opportunities for future corruption such as intensified identification of fraudulent providers, institutionalizing automated data analytics strategies and strengthening and fast-tracking legal processes.
PhilHealth said that “transparency is important in restoring public trust in the corporation and we will strive to be as transparent as possible in these investigations.”
“We assure the general public that the corporation is doing everything and exhausting all efforts to minimize any loss and resolve issues we are currently being confronted with,” it added.
Anti-fraud mechanism
Senators said yesterday that strong mechanisms to detect fraud and anomalies in PhilHealth must be immediately put in place to help stop the bleeding of billions of pesos due to corruption.
Sen. Sonny Angara, chairman of the finance committee, lamented the situation in PhilHealth where some individuals and health care providers defrauded the government of billions in funds that should be going to Filipinos struggling to cope with their medical needs.
He said based on the testimonies of resource persons at the hearing of the Senate Blue Ribbon and health committees on Wednesday, it was clear that some unscrupulous PhilHealth officials, who have access to the database of members, are manipulating the processing of claims for their own benefit.