The Philippine Health Insurance Corporation (PhilHealth) is now investigating alleged fraudulent claims and activities involving some physicians and healthcare facilities.
The state insurer bared that around 3,000 cases of the said activities were discovered, including provision of false information and “upcasing” to gain higher benefit or payment.
“Ang kadalasan, kunwari sasabihin nila ubo’t sipon lang o kaya pneumonia. Minsan naman ay ikino-confine nila ang pasyente kahit di kailangan. Meron ring mga ghost patients,” Dr. Shirley Domingo, PhilHealth VP for Corporate Affairs, said in the Laging Handa briefing.
At least 2,000 questionable cases were recorded by PhilHealth last year, while around 900 cases are currently being investigated for cases tolled in 2021.
PhilHealth warned that the accreditation of health facilities with proven involvement in corruption will be suspended, while the license of physicians partaking in the practices will be revoked.
Meanwhile, PhilHealth is now fast-tracking the payment to its COVID-19 testing balances to the Philippine Red Cross (PRC). It added that 98% of its controversial P15-billion interim reimbursement fund (IRM) has been liquidated.
It also reported that the indemnification package for COVID-19 vaccine recipients who will experience adverse effects is underway and is set to be released next month. – Report from Louisa Erispe/AG-rir
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