The Commission on Audit (CoA) should thoroughly scrutinize the Philippine Health Insurance Corp.’s (PhilHealth) financial statements as it starts auditing the State health insurer over a slew of controversies hounding it anew.
Sen. Juan Edgardo “Sonny” Angara made the call as he welcomed CoA’s decision to conduct a special audit on PhilHealth, which he has been pushing for in response to the allegations of fraud that have emerged in recent months.
Angara said the State auditing firm must include the Interim Reimbursement Mechanism (IRM) policy being used by PhilHealth for settling claims on COVID-19 cases by health facilities to determine if the process is fair and aboveboard.
During the continuation of the Senate hearing on PhilHealth, senators grilled the agency’s top officials as they cast doubts on the agency’s IRM policy, which they noted became a system of cash advancement to some favored hospitals or health care institutions (HCIs).
Aside from the IRM policy, the Senate is also looking into the questionable PhilHealth Information Technology (IT) system project which lawmakers deemed to be overpriced.
Senators are also looking into ways on how Congress can help resolve the PhilHealth fund deficit which some officials of the agency attributed to rampant corruption and the COVID-19 pandemic.
Angara noted that the persistent lack of transparency and accountability have contributed to the financial troubles PhilHealth is facing today.
For one, Angara said CoA had issued a disclaimer of opinion for 2018 on the fairness of the presentation of PhilHealth’s financial statement due to questions about the benefits claims expense and doubts about the accuracy of the collections made by the corporation.
CoA also couldn’t establish the accuracy of PhilHealth’s restated financial statement for 2017 due to lack of complete and relevant documents to support it.
Angara said he is frustrated at the agency’s failure to “shape up” in spite of CoA’s repeated adverse findings on its financial records.
“Basically, what the CoA has been saying for many years now is PhilHealth has not been transparent because mayroon siyang mga understated or overstated income. Tapos 'yung benefit payments hindi supported,” Angara said.
Had PhilHealth been a private company, the lawmaker said its officials could have already been fired a long time ago.
“If you look at the previous accounting scandals involving big corporations, pag may eskandalo sa financials, pag may fraud, sinisibak 'yan. Hinihingi ng shareholders 'yan tsaka ng board of directors (If there is a scandal on the financial side, if there’s fraud, they will automatically be fired. Shareholders and the board of directors will ask for it),” he added.
In PhilHealth’s case, he said the requirement of accountability should even be higher considering that public funds are at stake.
“And yet the same actors are still in place and that’s why I’m wondering; kasi kung sa akin lang, kung pribadong korporasyon ito, matagal na nasibak 'yung mga taong in charge dyan sa mga financial statements (because for me, if it’s a private corporation, those people in charge of the financial statements would have long been removed from their positions),” Angara said.