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PhilHealth fund’s special audit eyed

Senate Minority Leader Franklin Drilon on Sunday urged the Commission on Audit to conduct a special audit on PhilHealth after he doubted its ability to cover the medical expenses of Filipinos in the next 10 years.

He doubted PhilHealth’s ability to do its job following the allegations of corruption in the agency. 

It had also been reported that PhilHealth had resorted to overpayment or non-payment of hospital claims in connivance with the so-called ‘‘PhilHealth Mafia.

In Sunday’s interview with dzBB, Drilon said an annual audit was not enough given that many issues had been raised against PhilHealth, including overpayment, underpayment and nonpayment of claims.

“We must conduct a special audit, review the system and strengthen the agency’s auditing department, Drilon said. 

But Senator Panfilo Lacson doubted if COA was capable of conducting an audit due to the extent of the corruption within the agency.

“I have been saying that the 1900 health service institutions and providers cannot be covered so they can just do a random, Lacson said.

Drilon again raised serious concerns on the anomalies in PhilHealth and its poor collection efficiency.

“It involves billions of pesos of public money. The government provides subsidy to PhilHealth to cover the medical expenses of the poor and the informal sector, which amounts to P257 billion next year and P319 billion by 2024 due to the implementation of the Universal Health Care Act, Drilon said.

“We should not stop until we get to the bottom of this issue, so we can come up with solutions and legislation to prevent corruption, increase the agency’s collection efficiency and improve claims processing and benefit development.” 

Drilon said the government had made massive strides in expanding access to a comprehensive set of health care services and medical coverage for Filipinos.

He warned that Filipinos would not be able to effectively be covered if the government would fail to address the root cause of the irregularities in PhilHealth and provide a system that could prevent corruption and enhance the agency’s performance. 

While there was overpayment, he said, there was also corruption. He said this was the reason for the failure to pay hospital claims. 

For the past five years, the agency registered P26 billion in net operating loss and had outstanding P48 billion in unpaid claims, to date, Drilon said. 

PhilHealth president and chief executive Ricardo Morales said the agency was considering tapping an international consultancy firm to conduct a thorough audit of its funds.

But Drilon said the Constitution had mandated the COA as the government’s auditing body. He said the agency might be able to outsource a private firm to audit their funds but COA must have the final say.

“One of the solutions we must look at is to strengthen the auditing department of PhilHealth. Auditing should be done on a daily basis, if possible, so that we can prevent irregularities to take place, causing billions pesos of taxpayers’ money, Drilon said.

Topics: Franklin Drilon , Panfilo Lacson , PhilHealth , Commission on Audit , Ricardo Morales
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