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Manila Bulletin devider Philippines devider National devider PhilHealth can handle 'upcasing' in COVID-related claims – Guevarra

PhilHealth can handle 'upcasing' in COVID-related claims – Guevarra

Published Apr 14, 2021 03:38 pm

Justice Secretary Menardo I. Guevarra on Wednesday, April 14, expressed confidence that the current leadership in the Philippine Health Insurance Corporation (PhilHealth) will remain vigilant against “upcasing” or overpayment of health claims related to the coronavirus disease (COVID-19).

Philippine Health Insurance Corporation (PhilHealth)
(MANILA BULLETIN)

“PhilHealth is currently looking into new incidents of ‘upcasing’ in relation to COVID claims,” Guevarra said.

“With a former NBI (National Bureau of Investigation) chief as President/CEO, PhilHealth can very well handle this new investigation,” he stressed.

“But the DOJ/NBI will be ready to provide assistance if requested,” assured Guevarra.

PhilHealth is now headed by Dante A. Gierran whose prior government post was NBI director.

Last year, Guevarra formed Task Force PhilHealth pursuant to the Aug. 7, 2020 memorandum of President Duterte who directed the DOJ secretary “to organize a panel for the conduct of an investigation on the various allegations of corruption and anomalies in the Philippine Health Insurance Corporation (PhilHealth), including the audit of the PhilHealth finances and conduct of lifestyle checks of its officials and employees.”

“The DOJ-led Task Force PhilHealth conducted a thorough investigation of 'upcasing' schemes last year and cases were thereafter filed,” Guevarra recounted.

The first complaint was filed by the NBI before the Office of the Ombudsman (OMB) on Oct. 2, 2020. Named respondents were former PhilHealth president and CEO Ricardo Morales and eight other former and current officials of PhilHealth on charges of alleged irregularities in the implementation of the Interim Reimbursement Mechanism (IRM).

Last Jan. 13, the NBI filed another complaint before the OMB against alleged irregularities over the P33.8 million that private health provider Braun Avitum received from PhilHealth’s IRM.

Respondents in the second complaint were Morales, 13 former and current officials and personnel of PhilHealth main office and PhilHealth National Capital Region (NCR) office, and three executives of Braun Avitum.

The complaints are still pending with the OMB.

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