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THE
Philippine Health Insurance Corporation (PhilHealth) is
investigating 217 cases of spurious claims by private
doctors and hospitals, an official statement said.
Last
year, 425 cases for multiple filing of claims were filed
against medical centers and practitioners, according to
the government-run health institution.
Health
Undersecretary Alex Padilla said estafa charges may be
filed against those responsible for the false claims, if
PhilHealth has already paid them.
If no
payment has been made, physicians and hospitals that
filed fraudulent claims can be liable for falsification
of documents, Padilla added.
Malacañang earlier ordered the health department to
investigate the fraudulent claims charged to PhilHealth
by medical facilities and private physicians that have
reached some P4 billion. “We have been investigating
this,” said Health Secretary Francisco Duque III on
Thursday.
Duque
added that the P4-billion losses in fraudulent claims by
medical establishments are even lower compared to those
lost when public insurance was still under Medicare.
Back
then, according to Duque, for every P100-billion losses
Medicare incurs, 33 percent comes from false claims.
But
since 2001, when Duque took over PhilHealth’s
presidency, this has decreased to 4 percent, he said.
He said
“stricter measures” like putting on hold incomplete
documents have been put in place to prevent PhilHealth
from paying falls claims.
“We also
want the public to be vigilant … don’t sign blank
forms,” noted Duque adding that individuals who do this
may be liable for charges. |
