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Home News Top Stories

PhilHealth mess: House bares payments for rejected claims

Maricel CruzbyMaricel Cruz
September 4, 2020, 1:30 am
in Top Stories
Reading Time: 4 mins read
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A house leader on Thursday slammed the Philippine Health Insurance Corp. (PhilHealth) board for the approval of more than P600 million in late payments to hospitals with rejected claims from 2011 to 2019.

At a congressional hearing conducted by the House committees on public accounts and good government and public accountability, Rep. Robert Ace Barbers said that since 2011, various hospitals all over the country have been claiming payments from PhilHealth. All these claims amounting to more than P4 billion have been rejected by the Protest Appeals and Review Department (PARD) of PhilHealth.

But in a sudden turn of events in May 2020, and without the required detailed evaluation of each claim, PARD reversed its decisions and granted its version of amnesty by paying all these hospitals, Barbers said. However, the board only allowed a little over P600 million to be paid, he added.

“How can the PARD and former SVP [Rodolfo] del Rosario justify this very anomalous deal? PARD is under the office of SVP Jojo del Rosario. With the lame excuse of helping these hospitals cope with the COVID pandemic, they suddenly became generous and considerate after years of neglecting these claims?” Barbers asked.

“First, each claim should have undergone detailed scrutiny and evaluation before being reconsidered. Second, how do you evaluate claims from two to nine years ago? Third, why the need to pay those claims that have undergone evaluation and have been rejected a long time ago for various reasons? Fourth, if the reason for resuscitating them is because PhilHealth erred, then these officials are liable for gross negligence and gross neglect of duty under the Anti-Graft and Corrupt Practices Act, for sitting on these transactions all these years,” Barbers said.

Barbers said “the board did not even do a simple due diligence and blindly approved the recommendations for “amnesty” from PARD and Del Rosario. They are all grossly negligent and entered into a deal that is grossly disadvantageous to the government.”

In a matter of days, Barbers said PARD has reversed years-old decisions and succeeded in getting a board approval for more than P600 million.

“It is just like peanuts for them,” Barbers said.

Senate Minority Leader Franklin M. Drilon, meanwhile, rejected a proposal by administration lawmakers in the House of Representatives to grant the President emergency powers to reform and reorganize PhilHealth.

“There is no use for emergency powers. We will oppose it in the Senate. The President can reform and reorganize PhilHealth without emergency powers from Congress,” Drilon said in a statement on Thursday.

“The President has vast power under the Constitution and existing laws to reorganize and solve corruption in PhilHealth. He appoints the members of the board. He can file administrative and criminal cases against erring and corrupt officials. He can order the suspension or transfer of personnel in the entire executive,” Drilon said.

Senate President Vicente Sotto III also rejected giving the President emergency powers, saying he already has extensive powers to implement reforms in PhilHealth and order a revamp.

Senator Francis Pangilinan said emergency powers are not the solution to corruption in PhilHealth.

He reiterated that if the President is serious about stopping corruption in Philhealth, he should fire Health Secretary Francisco Duque III.

He said charges should be filed against those behind the overpricing of test kits, testing machines and the billions pocketed by the PhilHealth mafia.

Drilon cited the law that he authored, the GOCC Governance Act or Republic Act 10149, which grants vast power to the President, through the Governance Council for GOCCs (GCG), to reform and reorganize government-owned and -controlled corporations.

“Congress has already delegated to the President, by virtue of RA 10149, the power to reorganize PhilHealth,” Drilon said.

Duque on Thursday said he was saddened by the decision of the Senate to recommend the filing of criminal charges against him amid the corruption allegations at PhilHealth.

“If the findings are by design so that they can remove me, let it be said that I have a constitutional duty to do my job unless the President says otherwise. If my service is no longer needed, I will go but I will clear the name of my father first because I have not caused any injury to the government. We may have differences in policies, on how to manage the pandemic and the like, but I continue to do my job despite the attacks made against my person,” Duque said.

Duque also asked the senators to be fair in light of the Senate’s recommendation, and even appeal for their understanding.

“These are not normal times and it is not easy for me to just accept all the blows. I attended the Senate hearing to cooperate with the Senate in ascertaining the truth. I am disappointed though that the Senate has recommended the filing of charges against me when I have not done any wrongdoing,” the Health chief said.

In response to the Senate’s recommendation that he committed “grave abuse of discretion or gross negligence” in releasing billions of pesos in IRM funds “without valid criteria for distribution,” Duque said he did not even participate in the deliberation or sign any document approving the fund releases.

“Is the Senate so intent in removing me that they invent a finding that is not supported by official documents?” he said.

“This is all just part of the job. First of all, I did not ask for this position. I was invited by the President to help him in his administration. You know that I have been a Health secretary before, right?” said Duque in an interview with ABS-CBN’s Teleradyo.

Duque said this is the second time, referring to his job as Department of Health Secretary. He was health secretary during the time of former President Gloria Macapagal-Arroyo.

“In other words, what else do I have to prove, right? Nothing, except to work for the country and to help the administration of President Duterte become a success. So I will just work,” stressed Duque.

Duque sits as chairman of PhilHealth, which is being hounded by corruption issues.

Duque has denied any link to the widespread corruption at the state health insurer, but several groups, including senators have been demanding his resignation.

Even before the fresh allegations of corruption at Philhealth, several senators asked him to step down as DOH secretary due to his weak leadership in dealing with the COVID-19 pandemic.

Duque told those asking for him to resign to wait first for the result of the investigation now being conducted by the Task Force PhilHealth on the alleged anomalies in the agency.

Willie Casas

Tags: Governance Council for GOCCsPhilippine Health Insurance CorpProtest Appeals and Review DepartmentRobert Ace Barbers
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Maricel Cruz

Maricel Cruz

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