Patient falsely declared as COVID-19 victim leads to case vs. PhilHealth officials, medical personnel


CEBU CITY— At least 11 officials and medical personnel of PhilHealth-Central Visayas and a private hospital here were charged Tuesday (Feb. 9) for their alleged involvement in anomalous coronavirus disease (COVID-19) claims.

Philippine Health Insurance Corporation (PhilHealth) (MANILA BULLETIN)

The filing of charges stemmed from the findings of the National Bureau of Investigation-Central Visayas regarding the case of a 41-year-old male patient who was admitted at Chong Hua Hospital (CHH) last March 30, 2020 after experiencing difficulty in breathing.
 
The patient, who was said to be jobless the last 10 years, was later transferred to the Vicente Sotto Memorial Medical Center (VSMCC) where he eventually died due to Hepatic Encephalopathy or Acute Decomponsated Liver Cirrhosis as secondary cause.
 
However, The NBI-7 investigation showed that eight officials of PhilHealth-7 and three medical workers of CHH allegedly colluded in facilitating fraudulent COVID-19 claims for the patient amounting to P197, 883.52 even if he was COVID-19 negative based on the swab test done at VSMCC.
 
The NBI 7 said the patient was claimed under the medical frontliner package and COVID-19 package.
 
“He was neither a health worker nor frontline in any capacity prior and during his period of confinement at CHH,” read the NBI 7 complaint that was filed before the Office of the Ombudsman for the Visayas.
 
The eight PhilHealth 7 officials were Arlan Granali, Acting Regional Vice President of PhilHealth-7; Francis Javier, MD, Chief-Health Care Delivery Management Division (HCDMD; Joan Tiu-Ayuson, MD, Chief-Benefits Administration Section; Josette Bacalso, fiscal controller; Reginald Mangubat, medical specialist; Anecito Camahalan Ramas Jr., social Insurance Officer; Anthonnette Lerios Maamo, Clerk III; and Kenneth Aguilar Donald, Social Insurance Assistant.
 
They will face charges for violation of Section 3 of the Republic Act (RA) 3019 or the Anti-Graft and Corrupt Practices Act, malversation of public funds or property thru falsification of public documents penalized under Article 217 of the Revised Penal Code, RA 6713 or the Code of Conduct and Ethical Standards of Public Officials and Employees and gross and grave misconduct.
 
The three personnel of CHH, identified as Sharon Rose Rosales, PhilHealth Supervisor of CHH; Jasmine Miguel, finance manager and Tiffany Bertulfo, Assistant Vice-President for Finance of CHH, were charged for violation of the Anti-Graft and Corrupt Practices Act, malversation of public funds or property thru falsification of public documents.
 
“The testimonial and documentary evidence gathered in the course of the investigation are sufficient enough to arrive at one logical conclusion, that conspiracy had existed between Chong Hua employees/officers and PhilHealth employees/officers,” the NBI-7 said.
 
CHH is the second private hospital in the city to be implicated in alleged fraudulent COVID-19 claims.
 
Last October 29, 2020, the NBI-7 filed similar charges against officials and workers of PhiIHealth 7 and Perpetual Succour Hospital.