Raps filed vs former PhilHealth chief, others

MANILA, Philippines — The National Bureau of Investigation (NBI) has filed graft charges against former Philippine Health Insurance Corp. (PhilHealth) president Ricardo Morales and 13 others over the anomalous use of the interim reimbursement mechanism (IRM) fund.

The NBI-National Capital Region on Monday filed charges of graft and misappropriation of corporation funds under the National Health Insurance Act against Morales and PhilHealth officials Arnel de Jesus, Renato Limsiaco, Israel Pargas, Gregorio Rulloda, Imelda Trinidad de Vera, Lolita Tuliao, Gemma Sibucao, Lailani Padua, Cynthia Camacho, Recto Panti, Maricar Barangtay and Victoria Gatuz.

Three officers of the B. Braun Avitum Philippines Inc., which received the fund, were also charged.

According to the NBI, the dialysis center received P33.8 million in IRM funds before the pandemic despite pending administrative cases, such as seeking “ghost” claims for non-admitted or non-treated patients.

The NBI said PhilHealth and the center conspired to release the claims despite lacking documents.

PhilHealth also released the highest amount of IRM fund for the center even though the center did not indicate the amount it will avail, the NBI said.

B. Braun’s subsidiary Therapy Management Services Philippines received P15,967,900 in IRM funds.

The NBI investigated the reimbursement of PhilHealth funds amid allegations of ghost claims involving patients who had died but continued to receive state insurance.

Meanwhile, the Department of Justice (DOJ)-led Task Force (TF) PhilHealth endorsed the P1.1-million graft and corruption complaint filed by the Presidential Anti-Corruption Commission (PACC) to the Office of the Ombudsman, against 25 incumbent and former officials of PhilHealth in Region 1.

In a statement, DOJ Assistant Secretary Neal Vincent Bainto said the task force endorsed the PACC report after it was deliberated on and validated by the DOJ, and “we found it sufficient to be filed before the ombudsman. The TF PhilHealth concurs with the findings in the report.”

The PACC report centers its investigation on alleged fraudulent membership enrollment and fraudulent benefit claims done at the PhilHealth Regional Office I.

Investigations revealed that a fake account was created at PhilHealth Regional Office I under the name “Pamela Del Rosario” and contributions were retroactively applied and ante-dated.

Twenty-seven fraudulent claims, said to amount to P1.1 million, were made under this account.

“Based on the investigation, it appears that the claims submitted by this Pamela Del Rosario, and the payments made to her, were supported by fake receipts,” added Bainto.

The charges against the 25 individuals include falsification by public officer under Article 171 of the Revised Penal Code (RPC); malversation under Article 217 of the RPC; usurpation of authority under Article 177 of the RPC; violations of the Anti-Graft and Corrupt Practices Act under Republic Act (RA) No. 3019; violations of the National Health Insurance Act of 1995 under RA No. 7875, as amended by RA Nos. 9241 and 10606; and administrative liabilities for grave misconduct and conduct prejudicial to the best interest of the service.

The PACC report also recommended charging PhilHealth officials, employees tasked to investigate such alleged fraudulent schemes and their consequent failure to properly prosecute those involved in the incident. – Evelyn Macairan