Eye clinic files libel charge vs PhilHealth execs

MANILA, Philippines - Two separate libel cases, each seeking P2.5 million in damages, were filed yesterday before the Quezon City prosecutor’s office against Philippine Health Insurance Corp. (PhilHealth) president and chief executive officer Alexander Padilla and internal auditor Kim Gariando for accusing a private eye clinic of earning more than P150 million in benefit payments in 2014 through fraudulent claims.

A separate P34-million civil case for damages for abuse of rights and breach of contract was also filed  before the Quezon City Regional Trial Court against PhilHealth and its officials.

Raymond Evangelista, Quezon City Eye Center (QCEC) president, filed the civil case and libel charges.

“PhilHealth has stopped paying the pending claims of QCEC and announced the allegations and sanctions without giving the clinic due process and informing it of the charges before these were aired in the media through a press conference,” read the complaint filed through lawyer Lorna Kapunan.

The QCEC has consistently denied the allegations of PhilHealth that the eye center is involved in fraudulent practices.

“Despite the absence of proof and an absolute disregard for due process, PhilHealth immediately announced that it is suspecting QCEC of fraud and unethical marketing activities,” medical director and founder Edgardo Aguirre said in a statement.

“We firmly believe that the several actions of PhilHealth against us are unjust and laden with prejudice.”

PhilHealth has suspended reimbursements to the QCEC and three other eye centers due to alleged questionable claims for cataract operations.

PhilHealth has initiated an investigation after the claims of four eye centers, including QCEC, doubled in the past two years.

The jump in claims was due to the inclusion of doctors’ professional fees in the receivables of QCEC, the Quezon City-based eye center said in response to allegations of fraudulent claims.