As PhilHealth probers focus on IRM, officials told: Go on leave 

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PHILHEALTH officials were advised to go on leave amid an ongoing inquiry into alleged multibillion-peso anomalies involving questionable procurements, reimbursement claims and alleged manipulation of PhilHealth’s financial status.

This, as Senate President Vicente Sotto III said Wednesday Senate probers will also look into the ownership of a chain of dialysis centers that appeared to have been favored with early releases of millions of pesos under the Interim Reimbursement Mechanism (IRM) even as several big public hospitals handling many Covid cases suffered delayed releases.

Sotto was referring to the B Braun Avitum Philippines dialysis centers which have branches in Manila and Quezon City, and which are reportedly owned by a ranking PhilHealth official.

Sen. Panfilo Lacson, who has been leading calls in the Senate for a thorough investigation of PhilHealth, had pressed agency officials to explain the apparent favoritism in the releases of the IRM, such that even certain hospitals with hardly any Covid-19 patients received hundreds of millions in funds very early into the pandemic.

The IRM is a measure applied by PhilHealth to provide health-care institutions (HCIs) with emergency funds during unforeseen events like natural disasters, calamities and other fortuitous events, acocording to the agency’s explanation. This mechanism was previously tapped to respond to disasters such as Supertyphoons Ondoy and Yolanda, and recently with the Taal Volcano eruption. To prepare for a coordinated response to the pandemic which was just starting to unfold in March this year, PhilHealth said HCIs including dialysis centers and lying-in clinics nationwide were allowed to apply for IRM equivalent to their three months’ worth of benefit claims in 2019. In late May 2020, recognizing the clustering of cases in NCR, Regions 3, 4A, 4B, and 7, PhilHealth said it revised its strategy by scaling down releases only to these areas.

As of July 31, 2020, PhilHealth has released a total of P14.9 billion in IRM.

The favoritism in the release of IRM funding was one of the key points tackled at Tuesday’s second Committee of the Whole hearing of the Senate.

Call Duque–Drilon

Meanwhile, Minority Leader Franklin Drilon suggested it is time for the Senate probers to summon Health Secretary Francisco Duque, as chairman of PhilHealth, given the mounting issues against the agency. He also backed senators’ call for officials to go on leave.

Drilon also recalled that the first two hearings basically concentrated on the IRM and on the overpricing of the information technology (IT) programs.

“My take is that indeed, there is at least prima facie case of corruption and that corruption is embedded in PhilHealth bureaucracy,” said Drilon, adding that the DOH officials involved should take a leave of absence.

The senator suggested that “at this point, all those officials named should take a leave in order to prevent them from having access to the documents” noting that “many of what was revealed would involve documents and these are evidence that can be used.”

Noting that much of the Senate inquiry referred to the IRM and the IT purchase overpricing, he suggested that “the personnel involved without passing their guilt or innocence, should take their leave to enable the investigators to have full access to the documents and to prevent them from tampering with the evidence.”

“We already heard yesterday that one of them removed the signature page in one of the documents because it could be incriminating and this is in the approval on the purchase of IT equipment, which is allegedly overpriced,” he said. “I must state and warn that at this stage that the officials involved in the IRM could be liable for violation of the anti-graft law.”

Overhaul needed

Sen. Richard Gordon earlier pressed the need to overhaul the PhilHealth system.

Citing “corruption issues” chronically hounding government health insurer, Gordon stressed the “need to overhaul its system, or at least reshuffle or remove officials at the very least, to ensure that taxpayers’ money are spent properly.”
Gordon posed the recommendation, aside from proposing legislative measures, during Tuesday’s hearing of the Senate Committee of the Whole.

He recalled the agency’s history in notoriety, “from being used to provide ID cards for election purposes.”

Noting that many regional directors, until recently, have remained in their original posts for more than 20 years, Gordon said a reshuffle is called for at the very least. He said they have a lot to answer for because they could have stopped the malpractices had they been more stringent in verifying hospital reimbursements.

Gordon, who led the investigation conducted by the Blue Ribbon Committee last year on fraudulent medical claims to the PhilHealth, asked if he could submit to the Committee of the Whole the Blue Ribbon’s findings gathered.

Witness protection

Justice Secretary Menardo Guevarra on Wednesday said his department has yet to receive a formal request from the Senate to place under its Witness Protection Program (WPP) the whistleblowers in the alleged PhilHealth fund scam.

“We are awaiting the Senate’s formal request. We shall immediately evaluate upon receipt,” Guevarra said,

However, as of press time Wednesday, the Senate has yet to forward its request to the DOJ.

Senate President Vicente Sotto III has reportedly approved the proposal to place former PhilHealth anti-fraud officer Thorsson Montes Keith, board member Alejandro Cabading, and former head executive assistant Etrobal Laborte under the WPP.

Guevarra, who heads the task force conducting the investigation on anomalies in Philhealth, said the task force will meet on Friday along with invited resource persons to brief them on the various corruption activities in the agency.

“The DOJ Team met last Monday to discuss organizational matters and the operational strategy for Task Force Philhealth. We have scheduled a conference with the other members of the task force on Friday afternoon,” he said.

“We are presently inviting certain resource persons to give us a briefing on alleged irregularities at PhilHealth, so that we may clearly identify and prioritize the work to be done,” he added.

House hearing

The chairman of the House Committee on Public Accounts on Wednesday proposed the filing of plunder chargers against all officials involved in PhilHealth anomalies.

At a hearing of the House Committee on Public Accounts and House Committee on Good Government, Anakalusugan Rep. Mike Defensor, citing Commission on Audit reports, questioned the surge in the number of health claims.

He said these claims did not align with those reported by the Department of Health.

According to Defensor, the overpayments prompted the COA to recommend to PhilHealth to revisit its guidelines on all case rates payment system.

“[Because of this] I submit to the members of this committee, this in fact is plunder. This billions of pesos lost is tantamount to plunder,” Defensor said.

The lawmakers said charges should also be filed against employees from the regional level.

According to Defensor, Philhealth has lost an estimated P153.7 billion from 2013 to 2018 due to overpayment and fraud. Butch Fernandez, Joel R. San Juan and Jovee Marie N. Dela Cruz

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