PhilHealth President and Chief Executive Officer Ricardo C. Morales on Monday admitted there could be some bureaucratic “inefficiencies” within the state health insurer agency but belied allegations of large-scale collusion to commit graft.
PhilHealth, he said, processes a huge volume of claims that could go as high 50,000 on a daily basis. He, however, stressed no organized group from within exists to defraud the agency.
“So sa laki ng number, volume ng transactions na ’yan, may mga inefficiencies but I can assure you that there is no group of people colluding with each other to defraud PhilHealth in the scale reported. Wala. Meron tayong mga inefficiencies, meron tayong mali ang pagpasok ng dokumento, mali ang pag-fill up ng form but walang syndicate, or group of people, colluding to defraud the corporation at that scale,” Morales said in a Laging Handa briefing.
Morales came on the heels of Presidential spokesman Harry Roque’s “disappointment” over the lack of PhilHealth personnel who were held accountable for alleged irregular activities in the agency, referring to the WellMed dialysis scam wherein PhilHealth was made to pay millions in benefits to nonexistent patients.
Roque, who was a private lawyer at that time, was the legal counsel of two whistle-blowers of the said scam. He has also since alleged that the scam happened with the alleged help of PhilHealth officials.
Roque started issuing statements related to PhilHealth after Morales said they might run out of funds if they will continue to implement the Universal Healthcare law next year because of the Covid-19 crisis.
Roque insisted that PhilHealth is experiencing fund woes because of the irregularities, which are still happening in the government-owned and -controlled corporation.
Responding to Roque’s remark that he will recommend that President Duterte invite Morales so they could discuss how they could address issues in PhilHealth, Morales said he thinks “it is premature to go to the President without a solution.”
The PhilHealth chief also reiterated the Commission on Audit’s confirmation that it cannot find P154 billion losses in any of the 2013-2017 audited financial statements of the state health insurer.
Despite this, Morales said he believes there is no issue between him and Roque, adding that they are maybe at a “different frequency but pointing at the same direction.”
“So, it is just expected that people will scrutinize the corporation. But we are ready for this. We are ready to answer all allegations and we have provided information, data to the agencies, to the National Bureau of Investigation, the Presidential Anti-Graft and Corruption Commission, the Commission on Audit and we continue to cooperate with them so open kami sa lahat ng nagtatanong,” he said.
To resolve PhilHealth’s inefficiencies, Morales said they are working on an integrated, harmonized information system, noting that they are moving toward automation with a P2.5-billion budget for information technology this year.
“There’s no health-care system in the world na hindi fraud free. Walang fraud-free kasi hindi natin maaalis ’yung person to person transaction between the physician and the patient but pwede nating i-reduce ’yan if we have a perfectly integrated and harmonized information system but ’yung information system is not going to happen overnight. It will take some time before that would come into effect but ’yun lamang ang nakikita naming solution para sa mga inefficiencies at sa mga imperfections dito sa sistema natin,” he said.
He also assured the public that PhilHealth still has funds for this year amid the Covid-19 pandemic, noting it can still continue the same level of services.
“Yes, we started the year with a reserve of P130 billion. Ang estimate namin na price tag sa Covid is about P40 billion. So far ang nabayaran namin until April this year is about P52.5 billion. Yes we have money. We will be fine for the year, for the year 2020 and then maybe until the middle of next year so there’s nothing to worry about,” he said.