Senate to probe PhilHealth over alleged ghost claims, unpaid obligations


Posted at Aug 21 2019 01:52 PM | Updated as of Aug 21 2019 02:28 PM

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MANILA (UPDATE) - The Senate will investigate the Philippine Health Insurance Corporation (PhilHealth) for billions worth of alleged ghost claims and unpaid obligations, Sen. Bong Go said Wednesday.

Go, chairman of the Senate committee on health and demography, said PhilHealth president Ricardo Morales has told him the state insurance firm would cooperate.

Hearings will begin next week. 

"Sisiguraduhin ko po, sinabi ko po sa mga opisyales ng PhilHealth 'yung mga problema diyan sagutin niyo po kung bakit may mga fraudulent claims, bakit hinayaang may mga ganoong ghost claims," Go told radio DZMM.

(I will make sure, I told PhilHealth officials to answer the problems there, why there were fraudulent claims, why did they let ghost claims happen?)

"Ang taumbayan po ay nagtatanong, kailangan namin ng sagot. Ayoko pong may masayang kahit piso na pera ng gobyerno at 'di dapat nagmamakaawa ang taumbayan, pera nila 'yan eh."

(The public wants to know, we need an answer. I don't want a single peso wasted, the public shouldn't beg, that's their money.)

Senate Minority Leader Franklin Drilon on Tuesday said the Commission on Audit has agreed to conduct a special audit of PhilHealth's funds and disbursements.

Drilon urged PhilHealth to cooperate with state auditors, warning of serious consequences should the insurance firm fail to pay hospitals, especially public ones.

“There will be a chain reaction. The regional hospitals, especially public hospitals, cater to the poor through their maintenance and operating budget," he said.

"If PhilHealth does not reimburse them, the problem will become worse because they will not be able to serve the poor. It is really a very difficult problem."

The Chinese General Hospital and Medical Center last week said the state insurance firm still owes it P298 million in unpaid obligations, which might cause its humanitarian programs to buckle.

In June, authorities started investigating a report that a Quezon City dialysis clinic had made claims from PhilHealth on behalf of dead patients. 


Sen. Pia Cayetano, meanwhile, is seeking stiffer penalties for those found to be involved in the claims anomalies.

Cayetano said she is disappointed at PhilHealth’s failure to promptly settle hospital claims. She said many hospitals have been waiting for payment for six months now.

The lawmaker reminded PhilHealth officials on their obligation to settle hospital claims especially those that are performing well in the provinces.

“Ang sa akin, gusto kong pataasan 'yung (For me, we should raise the) penalty. Ipakulong natin and taasan 'yung (Let's jail them and raise the) penalty…imprisonment and fine,” Cayetano said Wednesday.

If private hospitals are forced to shut down over unpaid PhilHealth claims, the delivery of health services in the country will be affected as there are more privately-run health facilities here, she said.