Executives of the Philippine Health Insurance Corporation (PhilHealth) were grilled again regarding the issue on the Interim Reimbursement Mechanism (IRM) during the House inquiry on Monday.
The deliberation of lawmakers uncovered that cash advances meant for patients with COVID-19 were used for other purposes, including dialysis.
“Ibig sabihin, technical malversation po ‘yan. It was meant to be for COVID patients, ibinigay niyo sa non-COVID (It means, that is technical malversation. It was meant for COVID patients but you gave it to non-COVID). So public fund was used for a public purpose, but not for intended purpose,” Cavite 7th District Rep. Jesus Crispin Remulla pointed out.
PhilHealth Executive Vice President Arnel de Jesus responded that the IRM is not only used for COVID-19 patients.
“Iyon nga po ang pinapaliwanag namin na ang disenyo po ng IRM program ay para po sa risk response ng PhilHealth sa magiging posibleng magiging epekto sa buong sistema ng health care (We are explaining that the IRM program design is for the risk response of PhilHealth to the possible effects on the whole health care system),” de Jesus explained.
House Committee on Public Accounts Chairman Mike Defensor revealed that PhilHealth allocated Php 1.49 billion to 51 healthcare institutions through the IRM despite reported anomalies. It was found out that 4,664 fraudulent cases were recorded in the said institutions from 2013 to 2020, 768 of which are from 2013 to 2018 and 3,806 are from 2019 to 2020.
Defensor furthered that included in the alleged anomalies are post-dating claims, wrong information, and fake documents. The PhilHealth officials did not comment on the allegation of Defensor during the hearing.
“With so many hospitals here in Metro Manila, in other provinces, we should not allow those that have fraud cases, those that have penalties, to continue to have such funds,” Defensor advised.
Meanwhile, PhilHealth President and CEO Ricardo Morales apologized for his sudden departure during the past hearing. The hearing was temporarily suspended after de Jesus and PhilHealth SVP Rodolfo del Rosario had medical emergencies. – Report from Daniel Manalastas
