Solons question P600-million PhilHealth claims; Duque rues inclusion by Senate


A SENIOR lawmaker has revealed another anomalous deal involving officials of the Philippine Health Insurance Corp. (PhilHealth).

During a House hearing last Wednesday, Surigao del Norte Rep. Robert Ace S. Barbers asked PhilHealth officials on the approval of more than P600 million in late payments to hospitals with rejected claims from 2011 to 2019.

Since 2011, Barbers said various hospitals all over the country have been claiming payments from PhilHealth.  All these claims amounting to more P4 billion have been rejected by the Protest and Appeals Review Department (PARD) of PhilHealth.

In an unexplainable sudden turn of events last May 2020, without the required detailed evaluation of each claim, PARD reversed its decisions and decided to grant its version of an “amnesty” by paying all these hospitals, the lawmaker said.  However, he said the board only allowed a little over P600 million to be paid, out of a total of more than P4 billion in claims.

“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.

‘Not an easy thing’

Meanwhile, Health Secretary Francisco T. Duque admitted that attending to various concerns of his agency, Inter-Agency Task Force and PhilHealth are not “an easy thing.”

“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,” said Duque.

“How can the Senate implead me on Resolution No 2515 series 2020 [Annex A], of which I did not participate in the deliberation and did not sign the said document? Why are they pinning me when the rest who participated in the deliberation and signed the IRM resolution were not included? Is the Senate so intent in removing me that they invent a finding that is not supported by official documents?” he said.

In April 2020, 14 senators called on Duque to resign. Duque was included by the Senate’s Committee of the Whole in its PhilHealth findings on two counts: implementation of the Interim Reimbursement Mechanism and the failure to withhold tax liabilities of health-care institutions which Philhealth released IRM funds to, among others.

“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 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.

2 Senate reports

Meanwhile, Senate President Vicente Sotto III said he sees no conflict in two reports submitted by the Committee of the Whole and the Blue Ribbon Committee that conducted separate inquiries into the multimillion PhilHealth fund mess.

“As I said, malamang complementary kasi so yung pinapasabi kanina na narinig ko na palusot nung isa sa official ng dating PhilHealth, ang sinasabi ay bakit daw kami nag concentrate sa kanila, mas malala daw yung nangyayari sa hospital at saka sa mga doctor,” Sotto said, referring to the report of Blue Ribbon Chairman Sen. Richard Gordon.

Sotto noted that the Committee of the Whole did not tackle that issue anymore. “It was Senator Gordon and the Blue Ribbon that tackled that issue, we did not,” referring to the Senate Committee of the Whole hearings on the PhilHealth mess.

Moreover, Sotto observed that “the total of IRM funds involved and what happened to it was ‘unbelievable and unacceptable.”’

As 22 senators signed the report he did not foresee any problem in its adoption by the plenary so it can be promptly forwarded to the Department of Justice and the Office of the Ombudsman for appropriate action.

The Senate leader recalled that Duque was included for indictment being Chairman of the Board of PhilHealth. “Even if you consider what he says that he didn’t sign anything, but of course he didn’t because he is not voting; but he is the chairman of PhilHealth.”

Sotto advised Duque to look up Article 217 ng Revised Penal Code which directly dealt with malversation of public funds or property, noting it provides that “any public officer who by reason of the duties of his office is accountable for public funds or property, shall appropriate the same or shall take or misappropriate, or shall consent through abandonment or negligence, shall permit any other person to claim such public funds or property wholly or partially or shall otherwise must be guilty of the misappropriation of or malversation of public funds or property.”

He pointed out that “the chairman of the board leads the direction and the agenda of the board. “ I think Sec. Duque should get a good lawyer because he is practically admitting guilt to Article 217 when he says he doesn’t know.”

At the same time, Sotto admitted he was at first “reluctant to discuss the issue because of the pandemic,” but decided the Senate cannot close its eyes on the issue.

Jovee Marie N. Dela Cruz, Butch Fernandez

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