Senate President Vicente Sotto III said the forthcoming investigation of the multi-agency task force on the alleged irregularities in the Philippine Health Insurance Corp. (PhilHealth) should include anomalies dating back to 2013.
"I suggest they start from 2013 onwards...'Yon daw ang grabe start ng corruption according to PACC (The grave corruption started in 2013 according to the President Anti-Corruption Commission)," Sotto told reporters when asked for his comment on the creation of a "high-level" task force to investigate corruption claims at the PhilHealth.
President Duterte ordered on Friday the creation of the "Task Force Philhealth" to probe the alleged anomalous activities within the State health insurer. The task force will be led by the Department of Justice, and will invite independent constitutional bodies such as Commission on Audit (CoA), Civil Service Commission (CSC), and the Ombudsman.
The PACC earlier said that PhilHealth lost more than ₱153 billion to fraud since 2013, which was roughly 30 percent of the total claims payment of ₱512.6 billion. It also cited several fraudulent schemes allegedly employed by some employees, health care providers, and members.
Senate President Pro Tempore Ralph Recto said that more than firing and going after corrupt personalities, "changing the system...will stop the revolving door of anomalies" in PhilHealth.
In a statement Saturday, he enumerated his proposals to improve the management of the government health insurance firm and rid it of corruption.
Saying the PhilHealth needs a "constant audit," Recto said that the government should fill the over 5,000 job vacancies in the CoA.
"I doubt if CoA auditors in that agency number more than 25. Too small for a P140-billion-a-year agency, which transacts 35,000 claims a day from 8,500 hospitals and 40,000 healthcare professionals," he said.
"Invite millennials from the ranks of the 7,390 CPA board passers since January last year to fill these. This bigger CoA detachment should be reinforced with other CoA auditors to do fraud and performance audits from time to time."
He also proposed the appointment of a "resident Ombudsman" in the PhilHealth to prevent fraud.
The senator said the Executive department should also follow qualification standards for PhilHealth officials as stipulated in the Universal Health Care Act of 2019 (Republic Act No. 11223).
"For President and CEO, it should be seven years of experience in public health, management, finance, and health economics or a combination of any of these expertise. This should not be ignored or overruled by presidential discretion," Recto said.
PhilHealth executives and board members shall also be vetted by the GOCC Governance Commission to ensure that they are “fit and proper” to be appointed to the agency. "No GCG clearance, no appointment. That is the only way to get the best and the brightest, and not the recycled and reassigned."
He also urged the government to consider appointing an opposition representative to the PhilHealth Board.
"We need this embedded fair but firm fiscalizer. This will also benefit the appointing power, as no one will exercise greater vigilance than such an appointee," he said.
Meanwhile, Recto believes that the Cabinet secretaries who serve as ex-officio members in the PhilHealth Board should not be allowed to designate alternates or representatives.
"Unless lifted by the President, they should function as full-time, hands-on government and presidential representatives to the board. They can tap their squad of (assistant secretaries) and (undersecretaries) to assist them, but the latter should not be empowered to act on their behalf," he said.
He said the Cabinet heads are needed to "closely exercise oversight during the PhilHealth’s reform and rehabilitation phase."
Recto also proposed the strengthening of the PhilHealth's anti-fraud office to function as a "truly independent" internal affairs office.
"The Fact Finding Investigation and Enforcement Department (FFIED) and the Prosecution should be revamped. A revitalized antifraud group should be empowered to contract the services of outside experts, like auditors, if and when needed," he said.