Task force formed to stop PhilHealth corruption

MANILA, Philippines — An “exasperated” President Duterte yesterday ordered the Department of Justice to form a high-level panel to conduct a thorough investigation, do lifestyle checks and file criminal and administrative charges against Philippine Health Insurance Corp. (PhilHealth) officials involved in fraudulent claims and transactions through the years.

The President also called for an audit of PhilHealth finances and lifestyle checks on the agency’s officials and employees.

“Pursuant to the mandate of the Department of Justice as the principal law enforcement agency of the government, and its authority to investigate the commission of crimes and prosecute offenders, the DOJ is hereby directed to organize a panel for the conduct of an investigation on the various allegations of corruption and anomalies in the PhilHealth,” Duterte said in a one-page memo dated Aug. 7.

Presidential spokesman Harry Roque Jr. said the President wants the task force to be composed of the ombudsman, Commission on Audit (COA), Civil Service Commission, Office of the Executive Secretary and the Presidential Management Staff under officer-in-charge Melchor Quitain.

Duterte is “exasperated” over massive corruption at the agency, he said at a press briefing yesterday.

“My message to the alligators at PhilHealth: your days are numbered,” Roque said in Filipino, describing the corrupt as “buwaya.”

The DOJ probe will not be an ordinary investigation because it entails the conduct of lifestyle checks and administrative sanctions.

“As a lawyer, I think the President is exasperated. He wants to put a stop to all the corruption at PhilHealth and he really wants the task force he has created will have more teeth to carry out (the investigation),” Roque added.

To ensure the unhampered conduct of the investigation, the memo provides that the panel may, during the course of investigation, recommend to the President the imposition of preventive suspension on any PhilHealth official.

It also gives the DOJ 30 days to submit to Duterte the panel findings and recommendations, including the proposed legal action against officials and employees found responsible for acts of corruption or anomalies in PhilHealth.

Justice Secretary Menardo Guevarra assured the public of the agency’s independence in searching for the truth behind the anomalies.

Roque, who has been seeking reforms at PhilHealth, said he won’t hesitate naming those who will be removed from the agency for alleged corruption allegations which stemmed from alleged overpayments of claims, overpriced IT equipment, questionable release of funds and the reported manipulation of the agency’s financial status.

PhilHealth president Ricardo Morales yesterday welcomed the creation of a task force as he expressed confidence that nothing will be found on him.

“Very good,” Morales said.

According to PhilHealth spokesperson Shirley Domingo, the agency officials have agreed to voluntarily undergo lifestyle checks in a meeting of the executive committee yesterday morning or even before Roque announced the creation of the task force.

“This was discussed (yesterday) morning. We are submitting ourselves to lifestyle checks. We want to give a message that the ExeCom members do not steal money from PhilHealth,” she noted.

Domingo added they want to “debunk” allegations that some P15 billion were stolen from PhilHealth’s coffer by undergoing lifestyle checks by any agencies.

PACC probe

A Presidential Anti-Corruption Commission (PACC) report that said the government has been defrauded of about P154 billion in insurance claims to PhilHealth through the years has been submitted to Duterte.

PACC Commissioner Greco Belgica, in an interview with The Chiefs over TV5’s One News channel last Thursday, described the involvement of PhilHealth officials – from the executive committee and some members of the board down to mid-level managers in regional offices – as “connivance and conspiracy of criminal-minded people.”

Citing COA reports, he said the massive corruption activities at the state insurance firm “have caused the government over P154 billion conservatively” or an estimate of P2 billion a month.

“Our priority is to plug that by changing the technology solution which they are handling,” he added.

The PACC, which has teamed up with the National Bureau of Investigation to conduct a special audit on PhilHealth, identified the lack of the validation of billions of claims, which is traced to the flawed IT system operated by the agency, as the major cause of corruption.

Belgica said PhilHealth president Morales was also probed, but the PACC is leaving it up to Duterte to decide on subjecting the latter to disciplinary and administrative actions.

“The President knows best,” he said.

Belgica said the commission is mandated to conduct investigation on reports of corruption in government. Until the President sees the PACC report, Belgica said they can only conduct the probe and submit the recommendations.

The “power to fire people” remains the prerogative of the President because he is the appointing power. The PACC, however, can pursue and file charges before the Office of the Ombudsman against erring officials, without need for the President’s approval.

“The standing order to us is ‘do your job, file charges and bring me the evidence’. So, the trust of the President ends once he sees evidence against you. That’s our job. We are investigating Gen. Morales and he knows it,” Belgica added.

Duterte can fire concerned officials if there is substantial evidence to pin them down over the corruption allegations.

Morales has been subpoenaed by the PACC and has been responding to the queries of investigators, Belgica revealed. The agency has identified 36 individuals involved in the web of corruption inside the agency.

“As I said, Gen. Morales is under investigation. Our investigation did not stop on him or with him,” he added, without further detailing the names of those involved since the report has been submitted to the President.

According to Belgica, Morales is being investigated both for graft and corruption and the flaw in the PhilHealth system.

“Number one, there is an obvious system flaw and within the ambit of Republic Act 3019 or the Anti-Corruption and Practices Act,” he said.

He added that there is no system of validation in the claims of hospitals for insurance because PhilHealth is implementing a “weak and fragmented system” which was “intentional,” making it vulnerable to corruption.

The agency also uncovered cases of fake patients or claims for reimbursements. There are also cases of overpayments and rate adjustments.

Belgica said the PACC is focused on why the flawed system of reimbursing hospitals of their claims remains despite the numerous problems incurred through the years.

He also said that the initial testimonies at the Senate “confirmed our theories.” “That has been our findings from the beginning. It’s systemic, there’s IT problem and legal department problem, that’s why (corruption) never stops.”

Among the pieces of evidence the PACC has is the testimony of a hospital owner who was forced to cough up money for release of the hospital’s claims.

Belgica lamented that corruption prevailed in PhilHealth because no case was filed before the Office of the Ombudsman.

“The cases of those who were investigated in the regional level were whitewashed or dismissed once they reach the top… Nobody has been punished, so the people are still there,” he said. – Edith Regalado, Robertzon Ramirez, Sheila Crisostomo