DoJ, NBI to aid PhilHealth ‘upcasing’ probe

With a former NBI chief as president/CEO, PhilHealth can very well handle this new investigation, but the DoJ-NBI will be ready to provide assistance if requested

Justice Secretary Menardo Guevarra on Wednesday gave his assurance to state-run Philippine Health Insurance Corporation (PhilHealth) that the Department of Justice (DoJ) and the National Bureau of Investigation (NBI) will help in investigating fresh reports of “upcasing” in the state insurer.

He issued this statement following Philhealth’s pledge that it would probe the circulation of video posts claiming the resurgence of “upcasing scheme” where healthcare providers allegedly collude with patients to declare minor respiratory symptoms such as asthma as Covid-19 to claim higher benefits.

According to Guevarra, the DoJ-led Task Force PhilHealth has conducted a thorough investigation of upcasing schemes last year and cases were filed, now PhilHealth is looking into new incidents of alleged “upcasing” in relation to Covid claims.

“With a former NBI chief as president/CEO, PhilHealth can very well handle this new investigation, but the DoJ-NBI will be ready to provide assistance if requested,” he said.

The filing of criminal and administrative charges against seven officials of the agency for violation of the Anti-Graft and Corrupt Practices Act was recommended by Task Force PhilHealth for their alleged involvement in the multi-billion PhilHealth fund embezzlement.

It wrapped the investigation on the anomalies in PhilHealth but its composite teams are still continuing with investigations to determine the liability of others involved in similar or other wrongful practices in the agency.

Earlier, the task force endorsed the report submitted by the Presidential Anti-Corruption Commission to the Office of the Ombudsman recommending the filing of criminal and administrative charges against 25 incumbent and former officials of PhilHealth Regional Office I.