Senate recommends criminal, admin cases vs PhilHealth execs

MANILA, Philippines — The Senate Committee of the Whole on Tuesday bared the findings of its probe into alleged corruption and mismanagement within PhilHealth which ran throughout the month of August.

Senate President Vicente Sotto III during a plenary session said the following "grave" issues were unearthed throughout the series of hearings on the state-run agency:

1. The legal basis, or lack thereof, for the Interim Reimbursement Mechanism (IRM) and its "shoddy or shady" implementation
2. PhilHealth's information and communications technology project as an "anatomy of corruption"
3. PhilHealth's financial status, specifically:
   • The alleged manipulation of PhilHealth's financial statements, earlier flagged by the Commission on Audit
   • PhilHealth's Actuarial life: examining further the claim that PhilHealth will die in 2021 or 2022.
4. Irregularities in PhilHealth's Legal Sector 
5. PhilHealth's release of funds to B.Braun Avitum Dialysis Center

Recommended criminal charges, administrative cases vs PhilHealth officials

In addition to flagging these issues, the Senate recommended that the Department of Justice take the following legal actions against executives of the state-run agency:

1. Criminal charges against resigned Senior Vice Presient (SVP) Rodolfo del Rosario Jr. and other employees for the "failure to act upon prosecution of cases," as well as charges on negligence and graft for Del Rosario specifically
2. Charges of soft removal, concealment of documents and graft against SVP Jovit Aragona for the overpricing of information technology supply
3. Charges of malversation, illegal use of public funds, and graft against Health Secretary Francisco Duque III, who sits as PhilHealth's chairman of the board, ex-chief Ricardo Morales, SVP Renato Limsiaco, SVP Israel Pargas, Executive Vice President Arnel De Jesus for the illegal implementation of the IRM
4. Charges of malversation, violation of Internal Revenue Code and graft against Duque, Morales, De Jesus, Limsiaco and Pargas for failure to withhold tax liabilities related to the IRM
5. Administrative case against Morales and SVP Dennis Mas for not implementing board resolutions on courtesy resignations
6. Administrative case against Morales, De Jesus, for violating COA rules on period of liquidation
7. Administrative cases against Del Rosario, other officers of PhilHealth's Protest and Appeal Review Department for failure to act on pending cases

'No criteria' for over P14 billion released to hospitals amid pandemic 

PhilHealth's implementation of its Interim Reimbursement Mechanism, which is meant to help healthcare institutions to continue operations amid calamitous or fortuitous events, has been on the receiving end of intense scrutiny throughout the Senate's probe.

On Tuesday, the Senate alleged that the IRM was a "void and defective policy," saying "there was no set of criteria" for which healthcare institutions were qualified to receive money from the fund.

According to Sotto, prior implementations of the IRM had corresponding circulars which "set the requirement for PhilHealth accreditation."

He added that these requirements include the "sustained critical damage in infrastructure, and identification and validation of [PhilHealth] of the magnitude of damage or destruction of the HCIs."

"These circumstances are lacking or absent in the implementation of the present IRM in response to the pandemic, thus rendering its implementation void from the beginning," the senate president said.

The upper chamber found that 81 IRM requests from hospitals were submitted to the Central Office for approval from March 20 to April 20.

"If we are to consider the effectivity date of IRM based not only from its publication in a newspaper of general circulation but also on its submission of PhilHealth Circular No. 2020-0007 to the [Office of National Administrative Register], this would mean that the IRM effectivity is deemed valid only on June 11," Sotto said.

Despite this, the Senate moted 279 hospitals that had already received IRM funds from March 25 to April 22.

"Thus, we submit that the total IRM releases amounting to P14,038,393,329.14 from March 25 (earliest date of fund release) until 9 June 2020 were deemed illegal and invalid," Sotto added.