PhilHealth board approved P688-M illegal late claims –Del Rosario

Published August 25, 2020, 4:36 PM

by Jeffrey Damicog

The Philippine Health Insurance Corporation (PhilHealth) board has approved the payment of P688 million in late claims despite its being unlawful, an official of the state-run insurer has revealed.


Department of Justice (DOJ) Undersecretary Markk Perete said on Tuesday, Aug. 25, this was disclosed by PhilHealth Senior Vice President for the Legal Sector Rodolfo del Rosario on Monday, Aug. 24, during his testimony before Task Force PhilHealth which is investigating irregularities at the government corporation.
“May approval on the part of the board the payment of P688 million parang amnesty (The board has approved the payment P688 worth of late claims after being granted amnesty),” said Perete who cited the testimony of del Rosario.
Del Rosario, who testified along with PhilHealth Senior Vice President for Finance Policy Management Israel Pargas, said the board made the approval based on the recommendation of the Legal Sector following appeals made to give amnesties and allow the late payment of claims.
The undersecretary explained that under the law that created the PhilHealth, claims should be filed within 60 days after a patient has been discharged from the hospital, otherwise, no claims will be paid.
“The proposal to grant amnesty was approved by the Board but based on the testimony made before the Task Force, there is no payment yet,” the DOJ spokesman assured.
Perete said del Rosario was also grilled by the task force as to what legal basis was used for granting the amnesty.
“Isa itong ipinagtataka ng task force bakit, why are you taking the side of the hospitals na hindi nagbayad ng claim at that time (The task force is puzzled why the board took the side of the hospitals despite filing late claims),” said the undersecretary.
The DOJ spokesman explained the normal process would be for the hospitals to seek payment for the late claims by filing cases before the courts.
Perete said Task Force PhilHealth also learned from del Rosario that among the around 5,000 cases of fraud recommended for filing to the different PhilHealth regional offices,  only 11 were actually filed.
Because of this, the task force asked del Rosario for the records and inventory of all the around 5,000 cases including what hospitals or health providers were involved and how much were the claims.
“Sinasadya ba hindi mag-file ng kaso, yun mga na-file-an ng kaso maliliit lang ba claims na ito kaya allowed (Was the non-filing of cases intentional, where the claims small). These are the things we want to see, unfortunately di pa mabigay sa amin yun records so we can’t come up with conclusions (the records were not yet given so we can’t come up with conclusions),” Perete said.