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Manila Bulletin devider Philippines devider National devider Angara: Boost anti-fraud mechanisms at PhilHealth

Angara: Boost anti-fraud mechanisms at PhilHealth

Published Aug 29, 2020 06:12 pm

Sen. Juan Edgardo ‘’Sonny’’ M. Angara has called for a strengthening of the anti-fraud mechanisms of the Philippine Health Insurance Corp.on (PhilHealth) as part of the ongoing efforts to rid the institution of corruption or inefficient systems.

Sen. Sonny Angara (Senate of the Philippines / FILE PHOTO / MANILA BULLETIN)

Apart from pushing for the conduct of a special audit on PhilHealth funds following the most recent controversy faced by the State health insurer involving its allegedly overpriced information technology (IT) system and Interim Reimbursement Mechanism (IRM), Angara noted the weaknesses in the firm’s anti-fraud mechanisms have subjected its funds to abuse and misuse by some unscrupulous groups and individuals.

Angara, chairman of the Senate Committee on Finance, said it is high time for PhilHealth to digitize its records and to utilize systems to validate membership claims just like what is being used by pension funds Social Security System (SSS) and Government Service Insurance System (GSIS).

This was part of Angara’s recommendations as contained in a letter to Senate President Vicente C. Sotto III as the presiding officer of the Committee of the Whole (COW) that conducted three in-person and virtual public hearings on the PhilHealth mess.

“They (PhilHealth) should likewise look into strengthening their manpower complement by hiring more medical reviewers, anti-fraud officers, data scientists, data analytics personnel, and even experts in artificial intelligence and big data,” Angara said in his letter.

The need to immediately digitize its records was highlighted during the Senate hearings where now resigned PhilHealth president and CEO Ricardo Morales disclosed that there are about 5,000 members who are 130 years old and that nobody knows if they are dead or alive.

When asked whether he has failed President Duterte as the appointing power, Morales said he wanted to digitize operations at PhilHealth to reduce or eliminate corruption.

Earlier this week, a television report noted how a senior citizen was told that he was already dead for almost four years already based on his PhilHealth member data record.

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