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MANILA, Philippines – Two House committees on Tuesday approved the filing of administrative and criminal cases against Health Secretary Francisco Duque III and officials from Philippine Health Insurance Corp. (PhilHealth) for wrongdoing. The public accounts and good governance and public responsibility committees approved an 80-page report on their joint investigation into the state health insurer.
The report included findings on the implementation of the rate of all cases, the interim reimbursement mechanism (IRM), PhilHealth’s operation of an unauthorized payment system, disadvantageous resolution of cases, fraudulent claims, adverse audit reports and other alleged irregularities.
In a Viber message to journalists, Anakalusugan representative Mike Defender, chair of the public accounts committee, said the report also sought additional corrective legislation, such as eliminating mandatory premium contributions for Filipino workers abroad, a PhilHealth Crisis Act that grants emergency powers for the president to reform PhilHealth and amendments to the Universal Health Care Act.
The Inquirer published an exclusive story of the committees’ findings contained in a preliminary report last week.
3 conditions
Marikina Stella Luz Quimbo’s representative, a member of the blue ribbon committee, proposed three conditions before the national government publishes its P70 billion contribution to PhilHealth: a performance audit report detailing the policies and reforms to control the fraudulent practices; a fund viability plan, which includes policies and reforms to increase premium collection rates and minimize deficit risk; and a third-party review of PhilHealth.
During a hearing Tuesday, panel members rejected a motion by Bulacan representative José Antonio Alvarado Sy, chair of the blue ribbon committee, to exclude PhilHealth board members from the charges.
The joint House panel will present its report to the Department of Justice for further study.
The Senate plenary committee had previously recommended the filing of corruption and embezzlement cases against Duque, former PhilHealth president Ricardo Morales, and other senior executives for the release of MRI funds to health facilities that do not serve COVID-patients. 19.
Duque, as chairman of the PhilHealth board, was held responsible for the “flawed” mechanism of the MRI amid reports of preferential treatment for certain private health care institutions; the operation of a PhilHealth payment system without authorization from Bangko Sentral ng Pilipinas; and the revocation by the board of a court-confirmed stay order against Perpetual Succor Hospital of Cebu Inc.
‘Not signatory’
Duque denounced the charges, maintaining that although he was chairing the board, he was not a signatory to its resolution that paved the way for the IRM in March, as he was serving as chair of the Interagency Working Group for the Management of Emerging Infectious Diseases (IATF).
“They are implicating someone who did not sign [the resolution]. This is truly an injustice. Why are they insisting [on this]? The truth of the matter is that Congress removed the president’s voting rights, so the president is a non-voting member of the PhilHealth board, ”he told The Inquirer.
Duque was referring to the Republic Law No. 11223, or the universal health care law, where the secretary of health chairs the PhilHealth board as an “ex officio non-voting” member. The other four ex officio members are the secretaries of labor, welfare, budget and finance.
“Besides that, I was absent, attending my job as president of the IATF. This was at the height of COVID-19, when we were expanding, increasing the capacity of our healthcare system, ”Duque said.
He admitted that while the goal of the MRI was “good” in that it was intended to assist hospitals in their response to the pandemic, its implementation, which he stressed was the responsibility of management, not the board, was problematic.
“They are saying that in implementation, [funds were] it is not used for random events, for dialysis and other conditions… That will have to be determined by the courts, if the inclusion of other conditions like dialysis and cancer cases should have been part of the MRI application, “he said.
The House panels recommended that Morales be held accountable for the implementation of the IRM, the unauthorized electronic payment system, and the hiring of unqualified senior executives and changing the requirements for those positions.
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