PHILHEALTH CANCELS WELLMED ACCREDITATION

Philippine Health Insurance Corp. (PhilHealth) on Tuesday withdrew the accreditation of WellMed Dialysis Center, almost two weeks after the center was discovered as having defrauded the government by claiming payments for dead patients.

PhilHealth officer in charge Ruben John Basa said that because of its fraudulent claims, WellMed could no longer provide services to PhilHealth members starting June 18.

It means the Quezon City center can no longer file claims with the national health insurer.

“PhilHealth accreditation is a privilege granted to qualified health care providers for them to participate in the National Health Insurance Program. [This] can be withdrawn at the discretion of the corporation after due evaluation of their capacity and integrity,” Basa said in a statement.

On June 6, the Inquirer reported how WellMed had been defrauding PhilHealth since 2016 by claiming payment for dialysis service to patients who had already died.

It is estimated that WellMed got P808,600 in reimbursements by employing the scheme.

Following the Inquirer report, WellMed’s former employees Edwin Roberto and Liezel Aileen de Leon—who blew the whistle on the scheme—and owner Bryan Sy were arrested on June 10.

They were charged last week with estafa and falsification of documents. OnSunday, Sy was released after posting P72,000 bail.

Sy had Health Secretary Francisco Duque III as one of his principal sponsors at his wedding in 2014.

Payments stopped?

Basa pointed out that even before the withdrawal of WellMed’s accreditation, which was supposed to expire on Dec. 31, PhilHealth had already “ceased paying the said dialysis center for their claims.”

He, however, did not say when PhilHealth stopped paying WellMed.

Earlier, top PhilHealth officials said no payments had been made to WellMed since February.

PhilHealth internal data, however, showed that despite the center being flagged, it was still receiving payments this month.

From February to June, the center received close to P3.2 million in reimbursements, the data showed.

Duque had said these payments were the “subject of an investigation.”

As for the patients who will be affected by the withdrawal of WellMed’s accreditation, Basa said they may call (02) 441 7442 or visit PhilHealth’s website to know where they could go for continued PhilHealth services.