PhilHealth has P7.8B in unsettled notices of disallowance as of 2022 - COA

The Commission on Audit (COA) has flagged the Philippine Health Insurance Corporation (PhilHealth) over unsettled notices of disallowance (NDs) amounting to P7,857,710,895.05 across all regions in the country as of Dec. 31, 2022, some of which have been unsettled since 2008.

In its audit report, COA said that PhilHealth's head office has the highest unsettled NDs with P1,900,551,664.85, followed by Region III with P610,474,672.94. The National Capital Region (NCR) and Rizal came in next with P604,086,199.73.

It said that Region VI is fourth with unsettled NDs of P598,080,882.36, followed by Region V with P459,793,950.59 and Region X with P471,336,385.04. CARAGA is next with unsettled NDs of P408,040,851.88.

The other regions (in no particular order) that still have unsettled NDs are: Cordillera Administrative Region (CAR) with P340,055,104.63; Region I with P227,524,901.32; Region II with P339,129,375.90; Region IV-A with P285,331,163.63; Region IV-B with P358,781,931.90; Region VII with P283,597,209.22; Region VIII with P275,401,451.96; Region IX with P253,054,131.53; Region XI with P347,572,118.12; Region XII with P56,600,689.75; and Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) with P38,298,209.70.

COA said that in PhilHealth's head office, the longest-running unsettled NDs are from 2008 and they are dubbed as "extraordinary and miscellaneous expenses" (EME), ranging from P559.25 to P787,312.59. There have been motions for reconsideration filed for all EMEs, it said.

It also said that the head office also spent P49,285,894.89 for educational assistance allowance (EAA) for 2007; nominal gifts for 2007 worth P29,519,296.78; special events gift for 2007 worth P8,417,500; and birthday gifts for 2007 worth P5,974,572.83.

Other expenses included corporate transition and achievement premiums (CTAPs) for 2008 worth P81,059,403.54; Christmas packages for 2010 worth P36,135,000; hazard pay and laundry allowance for 2012 worth P58,838,724.52, COA said.  In 2014 the unsettled NDs were worth P95,462,027.42 and P67,963,774.58 in 2015, it said.

In NCR and Rizal, COA said the biggest ND was for salary adjustments from July 1, 2011 to Dec. 31, 2016 worth P105,292,158.29. The two regions have also NDS for Public Health Workers Benefits (PHWB) in 2012 with P32,317,653.41; in 2014 with P43,200,215.08;  and in 2015 with P52,270,370.05.

It said that in Region III, a lot was spent on shuttle service assistance -- P8,796,849.27 in 2013 and P3,576,000 in 2014. It also said the region also shelled out P16,551,719.57 for Christmas Assistance Package and Gratuity in 2014, and hazard pay and laundry and rice allowance for P33,522,445.10.  In 2015, the NDs were worth P21,594,365.84.

The biggest expenditure by Region III was for salary adjustment and differential benefit pay in 2016 worth P75,784,973.55, and welfare support assistance (WESA) in 2020 worth  P67,177,101.56, it also said.