Eye center backs probe on doctors in PhilHealth scam

An eye clinic in Quezon City backed yesterday the call made by the Philippine College of Physicians (PCP) to probe and penalize erring doctors who allegedly defrauded the Philippine Health Insurance Corp. through false reimbursement claims.

Edgardo Aguirre, medical director of the Quezon City Eye Center (QCEC), said he and his institution have always been supportive of any effort to rid the profession of bad eggs.

The QCEC is one of the eye clinics accused by PhilHealth officials of being engaged in fraudulent claims.

Aguirre maintained that PhilHealth acted arbitrarily when it suspended the payment of claims due to QCEC without following due process.

“We are open to any investigation and we are even supportive of any effort to weed out the bad eggs in our industry. But PhilHealth violated our right to due process and, in doing so, damaged our reputation beyond repair,” Aguirre said.

He said PhilHealth suspended payments even without finishing its audit report and without giving eye clinics a chance to show documents to prove innocence.

He said PhilHealth has not shown any evidence to link QCEC to the controversy “aside from presenting bloated figures that we strongly contest, to the detriment of our reputation that we fear we cannot recover from.”

He said the PCP knows that any doctor is only worth the reputation he or she has.

“What PhilHealth did was a summary execution of our reputation,” he said.

H e said PhilHealth dragged the good name of the QCEC into the national limelight in the Senate hearings, which crucified the clinic in the eyes of the public.

Aquirre also welcomed the Senate investigation as it has now exposed the deficiencies of PhilHealth.

Earlier, QCEC accused the agency of violating its own Circular No. 54 issued in 2012 which states that any institutional health care provider (IHCP) found in violation of agency circulars shall receive feedback from PhilHealth “requesting for prompt action to implement corrective measures addressing said violations.”

It directs the IHCP to “submit a plan of action to correct the same within 15 days from receipt of feedback from PhilHealth.”