MANILA, Philippines — An anti-crime watchdog is demanding the resignation of two Philippine Health Insurance Corp. (PhilHealth) officials for “criminal negligence that enabled scammers to raid its coffers.”
In a statement, Volunteers Against Crime and Corruption president Arsenio Evangelista said the chief technical officer and chief information officer, whom he did not name, are responsible for the recurring financial scandals that hounded PhilHealth.
The agency failed to institute appropriate software systems, business process rules, centralized patient health management records and risk management engines that would have prevented “ghost” kidney treatments and billings, he said.
Evangelista noted that then PhilHealth vice president Dr. Madeleine Valera testified in a 2007 congressional hearing that from 1995 to 2007, the agency lost as much as P4 billion due to fraudulent claims.
He added that PhilHealth was flagged last year for disbursing P12.69 billion in hospital bills for 810,000 members purportedly stricken with pneumonia.