Ex-Army general to head PhilHealth

MANILA, Philippines — A retired military general is taking over the scandal-ridden Philippine Health Insurance Corp.

PhilHealth officers confirmed that retired general Ricardo Morales went to the agency yesterday to meet with them.

“He met and talked with the officers, but he himself told us that he has no official appointment papers yet,” PhilHealth spokesperson Shirley Domingo said in an interview.

But Domingo said she heard in the news that President Duterte’s former aide, senator-elect Christopher Go, confirmed Morales’ appointment. A month ago, Morales was also appointed as member of the Metropolitan Waterworks and Sewerage System (MWSS) Board of Trustees.

“Maybe his appointment paper (for PhilHealth) was signed after he met with us,” Domingo said.

She declined to divulge what Morales discussed with the PhilHealth officers. A source at the agency said Morales also met with officer-in-charge Ruben John Basa.

Health Secretary Francisco Duque III earlier announced that Morales was appointed as PhilHealth acting president and chief executive officer. Some officials of the Department of Health (DOH) also said they heard of the appointment but that there is no official announcement yet.

But Morales’ appointment may face rough sailing as the Universal Health Law requires a PhilHealth president to have a seven-year experience in public health and finance. He served for a few years as president of the Armed Forces and Police Mutual Benefit Association Inc.

Last week, the President asked former PhilHealth chief Roy Ferrer as well as the six appointed board members to step down amid the ghost dialysis controversy.

Meanwhile, due to fraudulent claims, PhilHealth said it has suspended and imposed penalties on over 800 medical facilities and doctors.       

Aside from WellMed Dialysis Center, PhilHealth also revoked the accreditation of 21 health facilities and 35 health care professionals, suspended at least 147 health facilities and professionals and imposed fines on more than 600 facilities and professionals. 

Thirty-nine cases are now pending before PhilHealth’s Arbitration Office against WellMed.

PhilHealth admitted that there have been many fraudulent activities detected in the agency as it stressed that appropriate actions have been taken. It added that, since 2008, PhilHealth denied 1,294 applications for the renewal of accreditation and withdrew the accreditation of 71 providers.       

“To say PhilHealth has not been taking action is an utter lie,” PhilHealth said in a statement, noting that the corporation has filed at least 13 criminal complaints against health providers, 200 cases against erring employers and 26 cases of unethical behavior against doctors before the Professional Regulation Commission.

As this developed, PhilHealth denounced a series of published articles (not in The STAR) on the fraud and corruption plaguing the agency.

“There is seemingly orchestrated efforts of people within and outside the corporation to destroy the name of PhilHealth and undermine its efforts in fraud identification and control,” it said. “PhilHealth does not condone such acts.”

Regarding the case of Pamela del Rosario, who connived with a former PhilHealth employee in collecting P1.17 million from 2010 to 2014, the agency said appropriate cases have been filed before the Office of the Ombudsman and the courts.

On the fake receipts amounting to over P1.2 million that were issued to overseas Filipino workers in 2015, PhilHealth reported that it has already collected P208,800 from recruitment agencies, with the remaining balance now awaiting settlement or charges have been filed.

PhilHealth gave assurance that its fund remained secure and that measures are continuously being undertaken to detect fraud.

Meanwhile, Sen. Panfilo Lacson said yesterday that President Duterte should pursue an overhaul in the management of PhilHealth on top of the filing of charges against those involved in the alleged multibillion-peso scams.  

He said appointing officials with proven competence and integrity is an important step to significantly reduce corruption at PhilHealth, whose budget is expected to swell to at least P300 billion annually as the government is set to provide free health services to all Filipinos starting September.

“If there’s a problem in the system and it remains there, and a new leader or manager comes and still nothing happens, that only means that it’s business as usual,” the senator told radio dzRH.

He said the rank and file and middle management often observe their new superiors and see whether or not the higher ups are serious in reforming the agency.

“If the ex-officio chairman of the board is involved in a case of conflict of interest, how will he be respected by his subordinates?” he said, referring to Duque who allegedly owns a building in Dagupan City, Pangasinan where PhilHealth leases space.

Antonio Leachon, former independent director of PhilHealth, proposed the tapping of a private external auditor for the agency for at least a few years as he recalled that he once recommended to “audit the auditors” by calling in probers from the SGV but was told this was prohibited under government regulations.

He said the Commission on Audit personnel are few and the system is that the scrutiny happens only after transactions are done.

“We need a preventive (system). We need to invest right now in fraud mitigation and prevention,” Leachon said in a television interview.

He said the cost of tapping an independent external auditor is much cheaper even in the short term, compared to the billions that may be lost through fraud and inefficiency. Such a system can be implemented for a few years until PhilHealth has made its operations more resilient from corruption and inefficiency.

He noted that PhilHealth funds would run into trillions of pesos in the next 10 years, especially with the enactment of the UHC Law. 

Leachon, however, stressed that he believes more than 90 percent of officials and employees in PhilHealth are upright “with their hearts in the right place.” – With Paolo Romero