Metro Manila (CNN Philippines, January 12) — The National Bureau of Investigation has filed a new complaint against former Philippine Health Insurance Corp. chief Ricardo Morales and other PhilHealth officials before the Office of the Ombudsman over irregularities in the release of the state insurer’s funds.
The NBI on Monday recommended the charges for alleged violation of the Anti-Graft and Corrupt Practices Act, Misappropriation of Funds of the Corporation, and administrative cases of Grave Misconduct, Gross Negligence and Conduct Prejudicial to Public Interest. Aside from Morales, respondents to the case were executive vice presidents Arnel de Jesus and Renato Limsiaco, senior vice president Israel Pargas, and 11 other officials from Metro Manila and other regions.
Arsenia Ladores, Eduardo Rodriguez, and Ricky Pagligawan of dialysis center B. Braun Avitum were also named in the complaint for conspiring with the PhilHealth officials over the release of ₱ 33.8 million worth of funds under the insurer’s interim reimbursement scheme. The complaint said this allotted amount was higher than the correct allowable IRM fund to health care institutions.
“It is also worth stressing that PhilHealth failed to organize a validation team as required by PhilHealth Circular 2020-0007, which is necessary to assess the effects of COVID-19 pandemic and properly determine the percentage of allowable IRM fund to be granted to the requesting health care institution,” the complaint read.
Under PC 2020-0007, PhilHealth is only supposed to provide funding to those that were directly hit by “fortuitious events” with clear and apparent intent to continuously operate.
Meanwhile, on Tuesday, Task Force PhilHealth has also endorsed to the Ombudsman the investigation by the Presidential Anti-Corruption Commission on the involvement of the Northern Luzon regional office of PhilHealth over the use of a fake account for making fraudulent claims.
Justice Undersecretary Neil Bainto said in a statement that criminal and administrative complaints were recommended against 25 incumbent and former PhilHealth officials who were not yet named, but “majority of whom are from the regional office.”
The probe stemmed from a fake account under the name “Pamela del Rosario” at the North Luzon office which generated 27 fraudulent claims. paving the way for contributions that were retroactively applied and antedated. Charges were also recommended against PhilHealth officials and employees for their failure to investigate and properly prosecute those involved in the incident.
The charges include falsification of public documents under Article 171 in relation to Article 172 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, and administrative liabilities for Grave Misconduct and Conduct Prejudicial to the Best Interest of Service.
Task Force PhilHealth, headed by the DOJ, “shall continue to pursue further targeted investigations on the alleged corruption and anomalies” in the agency, Bainto noted.
