PhilHealth eyes tieup with PSA vs death claims fraud

MANILA, Philippines — The Philippine Health Insurance Corp. (PhilHealth) is eyeing a partnership with the Philippine Statistics Authority (PSA) for possible sharing of death statistics to combat fraudulent claims.

According to Shirley Domingo, PhilHealth vice president for corporate affairs, they have been coordinating with PSA to determine who among PhilHealth members have already died. 

“Even before the WellMed (Dialysis Center) issue, we are already in talks with PSA about data sharing. If they can share with us, or if they can tag us if a person passed away,” she said.

Domingo noted PhilHealth has no system to determine if a member is already deceased, unless it was reported to them.  

She added they are drafting a memorandum of agreement with PSA but admitted data sharing is not easy because of the limitations under the Data Privacy Law. 

Domingo said PhilHealth receives “a million claims” a month from accredited healthcare facilities and health professionals. 

So unless they have a data sharing program with PSA, it is not easy for PhilHealth to effectively identify fraudulent claims for dead members. 

On the other hand, Senate Minority Leader Franklin Drilon urged the PSA to enhance its data sharing capability.

Drilon, principal author of the Philippines Identification System Act, said the law’s objectives will be achieved more efficiently if PSA would be more open to sharing the data relevant to service delivery.

“The establishment of a single national ID system and an effective data sharing between and among government agencies could help prevent fraudulent transactions from arising in the future,” Drilon said.

Drilon dismissed claims the fact of death of a person is a privacy issue. 

He explained the fact of death is not a sensitive personal information that PSA should withhold, particularly if it involves the disbursement of public funds.

“What danger would it pose to the deceased person, or his or her family, if PhilHealth knows that he or she is already dead?” Drilon asked.

“None. This is just a factual question answerable by yes or no, but is very important for PhilHealth and other agencies disbursing public funds for the benefit of claimants to know in order to verify the legitimacy of a claim and prevent fake, illegal and fraudulent transactions,” Drilon said. – With Paolo Romero