House panel asks NBI to investigate possible plunder in P240-M PHilhealth fraud

Published August 27, 2020, 5:25 PM

by Ben Rosario

A joint House of Representatives panel on Thursday asked the National Bureau of Investigation (NBI) to look into a “clear plunder case” against former and incumbent officials of the Philippine Health Insurance Corporation and operators of a Metro Manila private hospital who may have colluded in defrauding Philhealth of some P140 million  in 2011.


At the continuation of the joint hearings on alleged Philhealth fund anomalies, members of the House Committees on Public Accounts and on Good Government also aired their intention to ask the NBI to pursue cases of irregularities in the distribution of P14 billion in Interim Reimbursement Mechanism funds.

IRM funds amounting to P14 billion have been distributed to various hospitals supposedly to keep them financially afloat as they join the fight against COVID 19 pandemic.

However, Anakalusugan Partylist Rep. Mike Defensor noted that Philhealth gave funds even to hospitals and clinics that do not cater to COVID 19 cases, such as maternity and dialysis centers.

Making matters worse is the fact that IRM recipients included medical institutions with pending cases of fraud and other violations of Philhealth rules.

At Thursday’s hearing, Civil Service Commission Chairperson Alicia de la Rosa-Bala belied claims in the last hearing of Commissioner Aileen Lizada that she asked CSC officials to suppress information about pending administrative cases of Philhealth personnel and officials before the commission.

However, a cut of the video taken during the CSC meeting of Bala and commission officials indicated that she indeed mentioned that information about the case be withheld.

Deputy Speaker and SAGIP Partylist Rep. Rodante Marcoleta grilled Philhealth’s former SVP and chief legal officer  Edgar Asuncion on the P240 million overpayment made by Philhealth to the Hospital Managers Inc., operator of the Cardinal Santos Medical Center in 2011.

The amount allegedly represents the claims of 48,000 Philhealth members who availed of the services of the hospital.

To resolve the issue, the HMI went to court and later offered a settlement of P70 million with Philhealth.

Asuncion said the settlement was approved by the Philhealth board and was reviewed and upheld by the Office of the Government Corporate Counsel.

Marcoleta slammed Philhealth’s decision as he noted in 2010 HMI submitted a disclosure to the Securities and Exchange Commission that it has a liability of P140 million to its patients.

This SEC report, Marcoleta said, is a glaring admission that HMI owes Philhealth P140 million, not just P70 million that both HMI and Philhealth agreed to settle their differences.

The partylist solon aired strong suspicion of a collusion among individuals involved in the case in order to defraud Philhealth of at least P70 million.

Reacting to Marcoleta’s accusations, Cavite Rep. Elpidio Barzaga moved to have the issue investigated further by the NBI.

Defensor said he expects the NBI to file plunder charges based  on the evidence presented so far during the House hearings on the Philhealth controversies.