PhilHealth execs sued at Ombudsman over fake receipts

Complainants Sarmiento and Roque said PhilHealth officials failed to act on the fake receipts.
Philstar.com, file

MANILA, Philippines — Philippine Health Insurance Corp. officials are facing graft and administrative complaints at the Office of the Ombudsman for allegedly failing to act on fake receipts issued for premium payments of overseas Filipino workers.

The fake receipts reportedly caused PhilHealh a net loss of P16.854 million.

Ken Sarmiento, former head of the Philippine Overseas Employment Administration-OFP Operations Office under PhilHealth Regional Office-National Capital Region, filed the complaint Wednesday against Dennis Mas, Ruben John Basa, Narisa Sugay and Gilda Salvacion Diaz.

The officials have been accused of violating the Anti-Graft and Corrupt Practices Act as well as of dereliction of duty, grave misconduct, gross neglect of duty, grave abuse of discretion and conduct prejudicial to the best interest of the service.

Fake receipts

The Philippine Overseas Employment Administration-OFP Operations assigned administers the National Health Insurance Program for OFWs and their qualified dependents.

Sarmiento said the office discovered 224 questionable receipts issued between September 2015 and September 2018 that were allegedly issued by liaison officers of several land-based hiring agencies transacting at the Blas F. Ople Building in Mandaluyong.

All 224 receipts failed systems-verification procedures, namely the comparison of transaction details declared on the PhilHealth Official Receipts (PORs) and the transaction details in PhilHealth's records.

They also "miserably failed" the test for the presence of embedded security features, through inspection of the serial numbers and ultraviolent light exposures.

Complaints readied

Sarmiento drafted 15 affidavit-complaints over the fake receipts and submitted them to the Anti-Fraud Division of the National Bureau of Investigation as instructed by lawyer Edgardo Asuncion, PhilHealth senior vice president for legal services sector at the time.

Aside from the dubious PORs, another 868 photocopies of questionable Payor's Copy of PORs were received by Sarmiento's office, "and were found to carry false and fictitious transaction details.”

Sarmiento then caused the preparation of another six draft affidavit-complains submitted to the ad hoc committee created by then-PhilHealth Interim President and CEO Celestina De la Serna.

All of the affidavit-complaints submitted to the NBI and the said PhilHealth ad hoc committee remain pending without legal action “because these were systematically suppressed by several high-ranking officers" in the PhilHealth Head Office and its Regional Office in NCR, according to Sarmiento and Harry Roque, a lawyer and fellow complainant.

Sarmiento said he then obtained six case folders of hiring agencies containing falsified PORs until he was eventually reassigned out of the POEA-OFP Operations Office "against his will."

Inaction on corruption

Respondents Mas (then-Regional Vice President of the PhilHealth Regional Office in NCR), Basa (previously chaired the involved ad hoc committee), Sugay (chaired the ad hoc committee after Basa), and Diaz (OIC Vice President of the PhilHealth Regional Office in NCR) were all established by the complainants to have failed to take the proper measures in response to the questionable receipts.

All the elements listed under Section 3e (Corrupt practices of public officers) of the Anti-Graft and Corrupt Practices Act were said to have been violated.

"Respondents' acts caused undue injury to the Government, PhilHealth and OFW-PhilHealth members when they lost an estimate of [P16.584 million] in net unremitted premiums, which should have been received, were it not intercepted by unscrupulous Liaison Officers,” reads the Wednesday complaint filed by Sarmiento and Roque.

Evidence provided for administrative charges include "[r]espondents failed to prosecute knowing the commission of a crime" and "[r]espondents' action shows malice and deliberate intent to favor the violator of the law."

“In this case, it is undeniable that Respondents clearly intended to violate the law when they failed to act and prosecute offenders in relation to the fake PORs shown to them.”

Aside from the charges filed, the complaints also called for additional penalities to be meted against the respondents, including dismissal from service, cancelation of eligibility, forfeiting of retirement benefits, permanent disqualification from holding public office and the barring from taking any civil service exam.

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