PhilHealth lost ₱2 B in fraudulent IRM program, solons say
The Philippine Health Insurance Corp. (PhilHealth) lost at least P2 billion due to fraud in just a few months that it implemented the Interim Reimbursement Mechanism (IRM) that distributed over P14 billion to various hospitals in the country to finance their
operations against the COVID-19 pandemic.
The computations were presented by lawmakers at the resumption yesterday of the hearing jointly conducted by the House of Representatives Committees on Public Accounts and on Good Government on reports of massive irregularities at PhilHealth.
Also during the hearing, Anakalusugan Partylist Rep. Michael Defensor disclosed that Philhealth President and CEO Ricardo Morales and 13 other key officials of the agency have submitted signed documents waiving their rights under the Bank Secrecy Law.
Defensor, chairman of the public accounts panel, said the documents authorized the Anti-Money Laundering Council to examine the officials' respective bank accounts.
Also submitting signed waivers were Executive Vice President and COO Arnel de Jesus; Senior Vice Presidents Dennis Mas, Jovita Aragona, Nerissa Santiago, Renato Limsiaco Jr., Israel Francis Pargas, VP Shirley Domingo, lawyers Rodolfo del Rosario Jr., and Jonathan Mangaoang, vice president Oscar Abad, Area VPs Walter Bacareza and Francisco Soria and Sector Manager Bernadette Lico.
During the hearing, the two House committees unanimously adopted Defensor’s resolution asking PhilHealth to withhold any release of the remaining P15 billion IRM to stop the state insurer from further bleeding.
Defensor’s motion also called for the withdrawal of any amount already distributed to various hospitals.
However, the twin goals sought in the motion could be futile as PhilHealth had already decided to suspend the IRM program.
Its board had already granted the request of hospitals for an extension of 60 more days within which to liquidate the cash advances granted them.
During the hearing, Marikina City Rep. Stella Luz Quimbo disclosed that upon computing the IRM allocations, she noted a huge discrepancy in the distribution of IRM to various hospitals in the country.
She said a 25-bed capacity hospital in Bukidnon received P1.3 million per bed while the private hospital Holy Trinity in the Cordillera region got P800,000 for each of its 14 beds.
In comparison, the Lung Center of the Philippines and the Philippine General Hospital, both busy COVID-19 treatment centers, received an average of P197,000 per bed.
“Labis-labis ang naka-park na pondo sa mga ospital at nasa discretion nilang waldasin ang pera ng taumbayan. (Much funds have been parked in hospital that were given the discretion to squander the people’s money) ,” she said.
Based on her computation, the opposition lawmaker disclosed that PhilHealth lost P2 billion to fraud and another P541 million “in foregone investment opportunities.”
PhilHealth officials admitted that recipient hospitals are given the freedom to spend their IRM share on whatever expenditure requirement provided that this will help them to remain afloat and continue operating to address the pandemic.
Deputy Speaker and Laguna Rep. Dan Fernandez slammed PhilHealth’s reasoning, pointing out that a good number of the IRM recipients are dialysis clinics that do not treat COVID19 cases.
Senator Panfilo M. Lacson yesterday said that retired Brig. Gen. Ricardo Morales, president and chief executive officer of the Philippine Health Insurance Corporation (PhilHealth), and another ranking PhilHealth official are liable for malversation of public funds whose penalty is “reclusion perpetua” (life imprisonment).
The other official is Fund Management Sector Senior Vice President Renato Limsiaco Jr.
“In all cases, persons guilty of malversation shall also suffer the penalty of perpetual special disqualification and a fine equal to the amount of the funds malversed or equal to the total value of the property embezzled,” Lacson said, citing a provision of the Revised Penal Code (RPC) in his opening statement at the third in-person and virtual public hearing by the Senate Committee of the Whole.
“Kaya huwag ninyo asahan na papatawarin kayo ng sambayanang Pilipino,” he added. (Don’t expect that the Filipino people will forgive you).
Lacson said that Philhealth officials involved in the mess "would most likely swim in many cases" to be prepared by Department of Justice (DOJ) Secretary Menardo Gueverra once Senate President Tito Sotto III has submitted the records of the public hearing of the Senate Committee of the Whole.
No ‘palakasan’
There is no "palakasan" system in Philhealth cash advances to health care facilities amid the COVID-19 pandemic, Health Secretary Francisco Duque III assured on Tuesday.
Duque also maintained that he has "zero tolerance" for fraud and corruption.
In his opening statement, he said "PhilHealth is a program very close to my heart" as he recalled that his father and former health secretary, Francisco Quimsom Duque Jr. was the first to come up with the concept of a medical care plan for Filipinos.
"Its precursor, Medicare, was the brainchild of my late father, former Secretary of Health Francisco Duque. Consequently, my commitment to safeguarding the sustainability of the fund is very personal," Duque said.