'Ghost dialysis' blamed on corruption at Philhealth
Published Jun 6, 2019 05:09 pm
By Betheena Unite and Ellson Quismorio
Collusion and corruption within the Philippine Health Insurance Corporation (Philhealth) was blamed for the “ghost dialysis” involving a dialysis facility in Novaliches, Quezon City.
Acting Philhealth President and CEO Roy Ferrer (Philhealth / MANILA BULLETIN)
Acting Philhealth President and CEO Roy Ferrer on Thursday said what made the “ghost dialysis” modus possible is corruption and connivance between the corporation’s officials and erring health institutions that have been going on for years already.
“There is mafia inside Philhealth and there are lots of unresolved cases. Inventory showed that there are some middle managers who have different cases – civil and administrative, and they don’t want to be reassigned, perhaps somebody is protecting them,” Ferrer revealed in a press briefing.
The “ghost dialysis” modus was recently uncovered when two whistleblowers came out in the open and claimed that WellMed Dialysis and Laboratory Center located in Novaliches has been filing claims for dialysis sessions under a name of a patient who is already dead.
Philhealth pays for these claims as every Philhealth member is entitled to 90 free dialysis sessions a year.
The corporation, however, said that they have already suspended the payment of claims from WellMed since February this year.
A move to withdraw the accreditation of the dialysis facility is also underway, Ferrer said.
With this modus now out in the open, he blamed the existence of a mafia within the ranks of the PhilHealth, who are allegedly making fraudulent activities.
“Posible ‘yan, hindi puwedeng sabihin na lahat ng employees malinis, may gumagawa ng mali diyan (That is possible. Not all employees are clean, some of them would settle on doing illegal activities),” Ferrer said.
“A fact-finding team is looking into this. Hindi puwedeng mangyari kung walang collusion inside Philhealth (This cannot happen without the collusion within Philhealth),” Ferrer said.
He further revealed that middle managers are involved in various anomalies within the corporation, saying administrative charges have already been filed against 38 employees.
They are now suspended, Ferrer said. Their cases can be traced back to 15 years and “no one dared touch them.”
He also believes that these employees are being backed by the mafia inside the corporation, saying “they are helping each other.”
“There are leader managers who belong to the same frat and helping each other in order for them not to be reassigned so that the cases will not push through,” he added.
Moreover, Ferrer believes that the “ghost dialysis” modus is even bigger than what was uncovered in Novaliches.
This is even bigger than we think, Ferrer said as he encouraged whistleblowers to come out in the open and exposed more anomalies. He also vowed that Philhealth will protect them.
House probe pushed
Bayan Muna Party-List Rep. Carlos Zarate called on the House of Representatives to immediately investigate the anomalies and corruption allegations surrounding the government-backed dialysis treatments under Philhealth.
“Maraming namamatay dahil hindi nila kaya ang mataas na bayarin para sa dialysis treatments. Sa kabila nito, ay nakukuhang pang nakawan pa sila ng ilang mapagsamantalang negosyo (A lot of patients have died because they can't afford the high cost of dialysis treatments. In spite of this, some unscrupulous businesses still find a way to take advantage of them),” the Davao-based solon said Thursday.
Zarate was pointing to reports of “ghost dialysis” patients, which effectively drain money from Philhealth. This robs real dialysis patients of the chance to avail themselves of this treatment.
“It raises the question of the implementation of the Philhealth-sponsored dialysis,” he said.
According to the militant lawmaker, the government should study the possibility ending its reliance on Philhealth as far as dialysis treatment is concerned.
“We must also look into the possible removal of Philhealth from the equation and let the funds go straight to public hospitals. That would expedite treatments,” Zarate said.
Acting Philhealth President and CEO Roy Ferrer (Philhealth / MANILA BULLETIN)
Acting Philhealth President and CEO Roy Ferrer on Thursday said what made the “ghost dialysis” modus possible is corruption and connivance between the corporation’s officials and erring health institutions that have been going on for years already.
“There is mafia inside Philhealth and there are lots of unresolved cases. Inventory showed that there are some middle managers who have different cases – civil and administrative, and they don’t want to be reassigned, perhaps somebody is protecting them,” Ferrer revealed in a press briefing.
The “ghost dialysis” modus was recently uncovered when two whistleblowers came out in the open and claimed that WellMed Dialysis and Laboratory Center located in Novaliches has been filing claims for dialysis sessions under a name of a patient who is already dead.
Philhealth pays for these claims as every Philhealth member is entitled to 90 free dialysis sessions a year.
The corporation, however, said that they have already suspended the payment of claims from WellMed since February this year.
A move to withdraw the accreditation of the dialysis facility is also underway, Ferrer said.
With this modus now out in the open, he blamed the existence of a mafia within the ranks of the PhilHealth, who are allegedly making fraudulent activities.
“Posible ‘yan, hindi puwedeng sabihin na lahat ng employees malinis, may gumagawa ng mali diyan (That is possible. Not all employees are clean, some of them would settle on doing illegal activities),” Ferrer said.
“A fact-finding team is looking into this. Hindi puwedeng mangyari kung walang collusion inside Philhealth (This cannot happen without the collusion within Philhealth),” Ferrer said.
He further revealed that middle managers are involved in various anomalies within the corporation, saying administrative charges have already been filed against 38 employees.
They are now suspended, Ferrer said. Their cases can be traced back to 15 years and “no one dared touch them.”
He also believes that these employees are being backed by the mafia inside the corporation, saying “they are helping each other.”
“There are leader managers who belong to the same frat and helping each other in order for them not to be reassigned so that the cases will not push through,” he added.
Moreover, Ferrer believes that the “ghost dialysis” modus is even bigger than what was uncovered in Novaliches.
This is even bigger than we think, Ferrer said as he encouraged whistleblowers to come out in the open and exposed more anomalies. He also vowed that Philhealth will protect them.
House probe pushed
Bayan Muna Party-List Rep. Carlos Zarate called on the House of Representatives to immediately investigate the anomalies and corruption allegations surrounding the government-backed dialysis treatments under Philhealth.
“Maraming namamatay dahil hindi nila kaya ang mataas na bayarin para sa dialysis treatments. Sa kabila nito, ay nakukuhang pang nakawan pa sila ng ilang mapagsamantalang negosyo (A lot of patients have died because they can't afford the high cost of dialysis treatments. In spite of this, some unscrupulous businesses still find a way to take advantage of them),” the Davao-based solon said Thursday.
Zarate was pointing to reports of “ghost dialysis” patients, which effectively drain money from Philhealth. This robs real dialysis patients of the chance to avail themselves of this treatment.
“It raises the question of the implementation of the Philhealth-sponsored dialysis,” he said.
According to the militant lawmaker, the government should study the possibility ending its reliance on Philhealth as far as dialysis treatment is concerned.
“We must also look into the possible removal of Philhealth from the equation and let the funds go straight to public hospitals. That would expedite treatments,” Zarate said.