The investigation into allegations of corruption at the Philippine Health Insurance Corp. (PhilHealth) should not stop with the suspension of its interim reimbursement mechanism (IRM) but dig deeper into the alleged “mafia” or syndicate that siphoned off millions of pesos in cahoots with hospitals and other health care institutions, Senator Risa Hontiveros said Friday.
In an online interview, Hontiveros noted that the investigation should look into favoritism in the release of funds to hospitals, even if they were not located in COVID-19 hot spots.
Senator Sherwin Gatchalian said he believed there was a collusion between the so-called PhilHealth mafia and the favored hospitals.
Hontiveros and Gatchalian also noted that all funds disbursed under the IRM should be properly liquidated and accounted for before PhilHealth resumes the release of the health emergency funds.
Philhealth’s advance payment under IRM had reportedly reached P14 billion, but Commission on Audit (COA) records say the state health insurer was able to liquidate only P1 billion of this amount.
Senate Majority Leader Juan Miguel Zubiri said the suspension of the IRM was a good first step towards transparency that would allow COA and the Office of the Ombudsman to monitor and account for the early fund releases.
He said the release of large amounts of money to hospitals and other health care institutions without a clear disbursement program or budget request, particularly to pviate companies, was highly irregular and was open to all sorts of corrupt schemes.
This system, Zubiri also said, should be stopped until a proper accountability system is set in place or better yet use the funds to modernize government hospitals and making them at par with private facilities. "That is a better way of utilizing these public funds," he said.
Senator Francis Pangilinan said the suspension of the “leaky” hospital reimbursement system of PhilHealth is a temporary yet critical measure in the fight against corruption and more importantly, in efforts to lead to a better COVID-19 response that the people deserve.
"It's a step that should have been done earlier. If COVID funds for IRM system were pocketed, why the need to proceed with the system? " he said.
Pangilinan was among the senators who called for the suspension of PhilHealth’s IRM amid allegations of widespread corruption in its distribution.
He called for an independent body composed of state auditors, Health officials, and “credible” PhilHealth executives to examine the agency’s books to see where very centavo went, and to formulate proposals on how to stop the bleeding of funds.
"Let us use this time to purge the PhilHealth records of unauthorized recipients and other anomalous transactions and preserve whatever pesos are left in the agency's coffers," he said.
"It is also vital to protect the money coming in from members' contributions because this will help sustain the agency's fund life. And all this must be done quickly as the COVID cases continue to rise," Pangilinan added.
Senator Joel Villanueva said all releases of IRM should only be used for COVID-19 cases. Non-COVID cases should follow the regular processing of claims, he said.
"PhilHealth has all the power and authority to make it easier for hospitals and other medical facilities to expedite their regular process for claims. Private hospitals are already overburdened with the nonpayment of their claims, and if they are forced to close, our health care system might collapse," Villanueva said.
Only Senator Juan Edgardo Angara said there was no need to suspend the IRM yet, saying it had to be determined if it was responsive to the needs of the times.