COA reports rampant financial violations of Philhealth

Officials from the Commission on Audit (COA) on Tuesday said the Philippine Health Insurance Corp. (PhilHealth) violated audit regulations when it liquidated only P1-billion of the P14.7-billion advance payment under its Interim Reimbursement Mechanism (IRM).

Responding to Senate minority leader Franklin Drilon’s question, Cleotilde Tuazon, COA’s Director 4, said the P14.7-billion of advance payment under the IRM should have been liquidated a long time ago since it was released to them on April 6.

Tuazon said they informed PhilHealth President Ricardo Morales that the P14.7-billion should be liquidated already as much as possible so they would know the actual balance of the fund given to the regions.

“But as it is, around P1-billion pa lang ang nali-liquidate…But this does not mean that only P1 billion has been expended. There is no liquidation yet so they do not know how much of the amount has been actually spent,” Tuazon told senators during the Senate hearing on PhilHealth anomalies.

“That’s why we suggested, we requested na fast track o i-facilitate nila yung liquidation and then for those regions which have no many COVID cases they should give the balance, they should pull out those balances and give it to those regions na talagang maraming (where there are many) COVID cases.

“Kasi (because) it would be unfair naman na ang laki-laki ng pera ng isang region wala naman po siyang masyadong COVID cases and there are regions na ang dami nilang patients pero wala naman silang (if one region has so many funds but don’t have much COVID cases, while other regions suffer with so many patients yet they don’t have) enough funds for that,” she pointed out.

When Drilon asked if COA believes PhilHealth’s liquidation is already overdue, Tuazon said yes.

“It is overdue because as what I said the regulation of COA is within 60 days. But according to them they gave them 120 days. Whenever 80 percent of the amount given to them has been spent they can already liquidate,” she said.

“That's why our advice is by this time for us to be able to know how much was actually spent, what is the remaining balance in the health care institutions (HCIs) in the regions. They should fast track the liquidation already because that is already too long,” she added.

During the hearing, senators accused PhilHealth of playing favorites when it showed records revealing that Davao City-based Southern Philippines Medical Center got the highest amount of IRM from PhilHealth with P326-million, more than the UP-Philippine General Hospital (UP-PGH) based in the National Capital Region (NCR) which recorded more than 75,000 COVID-19 patients.

Sen. Panfilo Lacson also scored the agency for prioritizing the release of P45-million to B Braun Avitum dialysis center, including P15-million for its Tondo branch without knowing that the center is not registered with the Securities and Exchange Commission.

Lacson noted B Braun Avitum is referring clients to Gat Andres Bonifacio Memorial Medical Center and yet the latter has yet to receive the P20-million reimbursements from PhilHealth as of June 9, 2020.

The senator also questioned the possible favoritism by PhilHealth in Eastern and Western Visayas, citing records where PhilHealth Regional Office 6 sent the central office a request letter dated April 8 and a follow-up letter April 15, but did not receive a response until June 22.

In Eastern Visayas, Lacson said Gov. Ben Evardone complained that 10 district community hospitals in the province have not been able to get P24-million in IRM.

“Yet four private hospitals got funds amounting to P21.5-million. Kaya sabi niya mahirap na probinsya ang Eastern Samar bakit di sila makasingit? There’s a pattern here, bakit ganoon nangyayari, parang may favoritism sa pagpili sa Level 1 private hspitals na nakatanggap ng IRM funds, P21.5-million?”  Lacson pointed out.