PhilHealth post offered to doctor-businessman

MANILA, Philippines — After seeking the resignation of Philippine Health Insurance Corp. executives in connection with the fraudulent benefit claims scam, President Duterte has offered the top PhilHealth post to Dr. Jaime Cruz.

If Cruz accepts the offer, he will replace Roy Ferrer as president and chief executive officer of the state health insurance agency.

Presidential spokesman Salvador Panelo has yet to provide the background of Cruz. However, reports say that Cruz is CEO of the JTC Group of Companies, an aggregate of numerous companies in Metro Manila and Davao that franchises branded food concepts.

Panelo said Duterte discussed the PhilHealth issue at the start of the Cabinet meeting on Monday, wherein he asked Ferrer and other officials to submit their courtesy resignations.

He said the resignation would paved the way for an impartial investigation on the reported fraudulent claims from PhilHealth on behalf of dead patients.

The President’s action came after he urged the National Bureau of Investigation (NBI) to step up its investigation into the allegedly anomalous payment of PhilHealth claims to the WellMed Dialysis and Laboratory Center on behalf of patients who have long been dead.

Health Secretary Francisco Duque III yesterday gave assurance that the PhilHealth executives would heed Duterte’s directive for them to resign.

Duque said the officials would file their resignation, adding “the action of acceptance will be solely on the Office of the President.”

“What is clear initially is that acting president and chief executive officer Roy Ferrer and six other presidential appointees to the board have been told to tender their courtesy resignation. He did not mention about those next in line individuals,” Duque said, referring to Duterte. 

The DOH has yet to clarify with Executive Secretary Salvador Medialdea the turnover of responsiblities at the agency. 

Charged

A co-owner of WellMed Dialysis and Laboratory Center was charged before the Department of Justice (DOJ) yesterday in connection with the “ghost” dialysis claims.

The NBI filed charges of estafa and falsification of public documents against Bryan Sy, who was arrested on Monday while being interviewed at the bureau.

Sy was brought to the DOJ for inquest proceedings.

The NBI filed the complaint on behalf of PhilHealth after two former employees of the Quezon City-based clinic accused Sy of claiming PhilHealth benefits for “ghost” patients.

The complaint said Sy took advantage of a loophole in the patient’s death reporting system of PhilHealth.

Aside from Sy, named respondents in the NBI complaint were WellMed executives John Ray Gonzales, medical director; Claro Sy, chairman; Alvin Sy, treasurer; Therese Francesca Tan-Sy, purchasing officer; Dick Ong, administration officer, and physicians Porshia Natividad and Joemie Soriano.

The charge sheet also listed whistle-blowers Edwin Roberto and Liezel Aileen de Leon Santos, who exposed the clinic’s alleged “ghost dialysis scandal.”

The NBI alleged that the clinic received payments from PhilHealth for dialysis treatments although some of the patients had long died.

Roberto, former assistant manager of WellMed, said in his sworn statement that on March 30, 2016, Sy ordered him to try to apply for PhilHealth claims for two dead patients amounting to P2,600. He said he instructed Santos to prepare the forms needed for the claims.

He said before he resigned in March 2018, PhilHealth paid WellMed P600,600 consisting of 200 sessions for dead patients. There was also an unpaid claim of P208,000 for 80 sessions, which he said was eventually paid.

Roberto said PhilHealth settled a total of 27 claims amounting to P808,600.

The NBI also submitted the sworn statement of John Cueto, a PhilHealth special investigator, who said WellMed continued to file PhilHealth claim forms for their patients.

Sy, Roberto and Santos were arrested as they were attending the NBI probe on Monday. 

The agency justified the arrest, citing the Rules of Court, which allows warrantless arrests when an offense has just been committed and the arresting officer has reason to believe based on his personal knowledge and circumstances that the person to be arrested has committed it.

NBI deputy director for forensic service Ferdinand Lanvin said Roberto and Santos were included in the charge sheet so they can be allowed to apply for witness protection. – Edu Punay, Paolo Romero, Jess Diaz, Sheila Crisostomo, Cecille Suerte Felipe, Delon Porcalla, Rey Galupo