At loggerheads over alleged massive graft at the state-run Philippine Health Insurance Corporation (PhilHealth), officials will have another round of proving their accusations when the House of Representatives launches its initial hearing on the controversies on Wednesday.
A day after appearing in a congressional hearing at the Senate, PhilHealth officials headed by its president, retired Brig. Gen. Ricardo Morales, will again face intense grilling before the House Committee on Public Accounts chaired by Anakalusugan Rep. Michael Defensor.
“I will ask PhilHealth officials at tomorrow’s hearing to explain the recent claims of corruption that surfaced following the resignation of anti-fraud officer Thorrson Montes Keith,” said Quezon City Rep. Alfred Vargas, vice chairman of the House Committee on Appropriations.
Vargas and his colleagues were taken aback by the revelation in the Senate that PhilHealth will have no money left in its coffers by next year.
One of the authors of legislative measures proposing an investigation into the alleged PhilHealth anomalies, Vargas said it has become vital for the PhilHealth management to have a long-term fiscal management plan.
During the Senate hearing, Morales revealed that the government-owned medical insurance firm has a fraud index of 7.5 percent, estimated to over P10 billion possibly lost to anomalous transactions.
But Morales said this can be addressed with the installation of a strong information management system.
“PhilHealth officials must not only answer our questions, they must also account for each cent they receive from the government and the public,” said Vargas.
For his part, Deputy Minority leader and Bayan Muna Rep. Carlos Isagani Zarate today said that the prospect of a depleted PhilHealth reserve fund bolsters the Makabayan bloc’s " position that funds from the national budget should go directly to hospitals and not to PhilHealth,"
"As it is, PhilHealth seems to be so entrenched in corruption and syndicates that it is hard for us to trust it with people's money. They can't even answer why their IT resources were overpriced, as well as overpriced Covid testing, and a slew of other anomalies," said Zarate.
Defensor said Keith, Morales and other officials of PhilHealth and the Department of Health are expected to show up before his committee on Wednesday.
Defensor said Keith, in his resignation letter, also claimed that millions of overseas Filipino workers should not be made to pay for PhilHealth “spillages.”
“Mr. Keith should explain what these spillages are, what are the instances of corruption in the state health insurance firm, and who are the officials and personnel involved,” he said.
He said PhilHealth has had its share of corruption issues in the past.
Defensor cited an August 2019 Commission on Audit report that called out the agency for a suspicious surge in cases and reimbursement claims of members from Rizal and Metro Manila for pneumonia, urinary tract infection, acute gastroenteritis, sepsis, and other diseases.
He said tens of billions in “overpayments” were blamed on the “all-case rates” or case package payment mechanism.
“The case-rate system, under which there is a fixed cost for the treatment of certain diseases and for procedures, is really a loophole that is resulting in billions of losses on the part of PhilHealth. It is not surprising that it may be a source of corruption,” he said.