Twenty-five former and current officials of the Philippine Health Insurance Corporation (PhilHealth) face complaints before the Office of the Ombudsman (OMB) over alleged fraudulent membership enrollment and health claims in Region I amounting to over P1 million, the Department of Justice (DOJ) said on Tuesday, Jan. 12.
DOJ Assistant Secretary Neal Bainto said the DOJ-led Task Force PhilHealth has officially endorsed to the OMB the report of the Presidential Anti-Corruption Commission (PACC) on the findings of the investigation conducted against PhilHealth Region I.
“In the report, criminal and administrative complaints are recommended to be filed against twenty-five (25) incumbent and separated officials of PhilHealth, majority of whom are from the Regional Office,” Bainto said in a statement.
The 25 persons have been recommended to be held liable for falsification by public officer under Article 171 of the Revised Penal Code (RPC); malversation under Article 217 of the RPC; usurpation of authority under Article 177 of the RPC; violating Republic Act (RA) No. 3019 or the Anti-Graft and Corrupt Practices Act; violating the RA 7875 or the National Health Insurance Act, as amended by RA 9241 and 10606; and administrative liabilities for grave
misconduct and conduct prejudicial to the best interest of the service.
“Investigations revealed that a fake account was created at PhilHealth Regional Office I under the name ‘Pamela Del Rosario’ and contributions were retroactively applied and ante-dated,” Bainto disclosed.
“Twenty-seven (27) fraudulent claims were then made under this account,” added the assistant secretary who noted that the transactions amounted to a total of P1.1 million.
Bainto said the PACC report “also recommended charging PhilHealth officials and employees tasked to investigate such alleged fraudulent scheme and their consequent failure to properly prosecute those involved in the incident.”
Bainto declined to identify the former and current PhilHealth officials implicated in the PACC report.
“We'll withhold the names of the employees and officials in the meantime until they are officially informed through a subpoena,” he said.
Bainto said “it appears that the claims submitted by this Pamela Del Rosario, and the payments made to her, were supported by fake receipts.”
On the other hand, the DOJ official said no hospital officials and personnel have been included in the complaints.