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The Public Accounts Committee of the House of Representatives and the Committee of Good Governance and Public Responsibility of the House of Representatives recommended on Tuesday the filing of criminal charges against Secretary of Health Francisco Duque III, the former president and CEO of Philippine Health Insurance Corp. (PhilHealth) Ricardo Morales and other PhilHealth executives and four Cabinet members in connection with alleged corruption at the agency.
In their 65-page joint report, two panels approved the filing of charges for violating Section 3 of the Republic Law (RA) No. 3019 or the Corrupt Practices and Anti-Theft Law, and Article 220 of the Revised Penal Code on the illegal use of public funds against Duque, Morales, PhilHealth executives Arnel de Jesus, Israel Pargas, Rodolfo del Rosario and Rogelio Pocallan Jr., PhilHealth board members María Graciela Blas Gonzaga, Susan Mercado, Alejandro Cabading and Marlene Padua .
The committees, chaired by Anakalusugan representative Michael Defensor and Bulacan representative Jonathan Sy-Alvarado, also recommended the filing of the same charges against cabinet members who are on the PhilHealth Board, namely the Secretary of Labor Silvestre H. Bello III, Finance Secretary Carlos G. Domínguez III, Budget Secretary Wendel E. Avisado, and Social Welfare Secretary Rolando Bautista.
Overpayment
The committees also revealed that PhilHealth has an overpayment of up to P102 billion to hospitals under the fee system for all cases from 2013 to 2018.
“More importantly, the legal basis of the IRM [Interim Reimbursement Mechanism] it is not clear. Despite this, PhilHealth has distributed some P15 billion of funds to various health care providers across the country, ”the panels said.
IRM is an advance payment plan to give healthcare institutions cash upfront to respond to natural disasters and calamities.
“In what is arguably the most notorious case of corruption to date involving the corporation, PhilHealth officials involved in the illegal disbursement of public funds through this mechanism anchor their defense in fuzzy interpretations of the law. , none of which will be upheld in court, “the report added.
The committees said that while PhilHealth claims it is struggling financially due to the Covid-19 pandemic and claims that its remaining actuarial life has been shortened to one year, “the Joint Committees find, based on data provided in the various PhilHealth submissions , that PhilHealth has spent too much on Covid-19. “
“The most tragic result of the flawed MRI plan is that, despite the enormous advances made in favor of select hospitals, most of the payments are made for non-Covid-19 claims, thus eliminating the funds that could be used to ensure access to hospital care for Covid-19 patients when they need it urgently, ”the report says.
As of August 10, 2020, the committees said a total of approximately P2.39 billion of MRI funds had been liquidated, of which P1.21 billion has been liquidated by private healthcare institutions.
In addition to the lack of legal basis in the implementation of the MRI, the panels said that PhilHealth, in the implementation of its case-based payment system, has allowed the use of Covid-19 case rates for patients merely suspected or probable of Covid-19, and “this amounts to a legitimate form of transmission.”
The committees also noted the “disadvantageous agreement” made by the insurance agency with Perpetual Succor Hospital of Cebu Inc. (PSHCI), Cardinal Santos Medical Center (CSMC) / Hospital Managers, Inc. (HMI), WellMed Dialysis and Laboratory Center Corporation , Medina General Hospital (MGC), Accenture Inc., B. Braun Avitum Philippines Inc. (B. Braun) and Balanga Rural Bank Inc. (BRBI).
Legislative proposal
The panels also recommended passage of the proposed Philippine Health Insurance Corporation Crisis Act of 2020, which gives the president special powers to reorganize PhilHealth.
For this purpose, the President may delete or create positions; split, grouped or merged positions; transfer functions, equipment, property, records and personnel; institute drastic cost reduction measures and take the other related actions necessary to carry out the purpose stated herein.
The bill stated that the authority granted to the President under this proposal will subsist, be valid and effective for a period of one year from the effective date of this proposal, unless it is withdrawn or extended by resolution of Congress.
To protect Philhealth funds and cleanse the agency from bribery and corruption, the measure said the president can enter into negotiated contracts for certain services.
The bill also gives the president special power to reorganize PhilHealth to make it more effective, innovative and responsive to his current issues and concerns regarding the sustainability of funds and issues related to bribery and corruption, among others.
Flavor of the month
“I am always the flavor of the month.”
This was Duque’s reaction to the recommendation of the House committees to press charges against him.
He said they keep repeating the same problems he faced when he attended a Senate hearing in August.
“That issue has been around for a long time, August only in the Senate. The problem is the same [That is an old issue, in August that was brought up in the Senate ]. First of all [First], I did not sign the resolution approving the IRM [Interim Reimbursement Mechanism] implementation, ”Duque told BusinessMirror in a telephone interview and emphasized that he did not sign any documents“ because I was absent from March, April and May because I was appointed chair of the Inter-Agency Working Group ”.
Duque reiterated that, as president without the right to vote under the Universal Health Care Law, it is regrettable that it has been implemented in the alleged irregularities of the MRI.
He said he was not even present during the deliberation or signed PhilHealth Board Resolution No. 2515 of March 31, 2020.
“I took on the most important duty of heading the IATF, which at the time was responding intensively and aggressively to the massive problem of the Covid-19 pandemic,” he said.
Duque said he respects the decision of the Ombudsman’s Office after it issued a preventive suspension order against five members of the Health Department staff for alleged anomalies in the handling of the Covid-19 pandemic.
The Ombudsman investigated the following issues:
- the delay in the acquisition of personal protective equipment (PPE) and other medical equipment necessary for the protection of health workers
- alleged lapses and irregularities that led to the death of medical workers and an increase in the number of deaths and of infected frontline medical personnel
- inaction in the release and processing of benefits and financial assistance for those infected and those front-line physicians who succumbed to the disease
- confusing and late reporting of COVID-19 related deaths and confirmed cases
