The Philippine’s Problems with Ghost Patients

  • PhilHealth has been racked with controversy when the scandal about losing P154 billion to ‘ghost patients’ broke
  • President Duterte has called the scandal ‘unacceptable’
  • PhilHealth urged Filipinos to ‘take responsibility and accountability to protect NHIP.

The Philippine Health Insurance Corp. (PhilHealth) has been the forefront in handling Filipino’s social health benefits for over 24 years. But back in June, the government agency was rocked with controversy as they lost P154 billion to “ghost” patients and deliveries. 

One of PhilHealth’s services includes extending help towards Filipinos is providing financial aid to dialysis patients. The state insurer’s health coverage entitled each PhilHealth member to 90 free dialysis sessions a year. But this particular service has been abused by a particular company, racking up to millions of stolen money. 

Dead patients undergoing kidney dialysis, ghost patients getting cancer treatments and fake members are just some of the fraudulent schemes that led to at least P154 billion losses in PhilHealth. The Inquirer investigative team first reported the massive corruption in Philhealth from Jun. 6, till Jun 21, and they have uncovered a total of 24 stories regarding the incident. 

THE SCAM INSIDE PHILHEALTH

The Manila Times reported that whistleblowers Edwin Roberto and Liezl Santos, former employees of the privately run WellMed Dialysis Center and Laboratory Corp., shared that the scheme involved claiming and being released PhilHealth funds for dialysis treatment of dead patients. 

Image result for wellmed dialysis center
via The Philippine Star

The Inquirer also reported that Roberto and Santos went directly to the PhilHealth office in January. They were to follow up on the status of their complaints about their former company, but they were ignored. 

Apparently, the knowledge of payments for kidney dialysis treatments of dead patients has only been one of the many fraudulent acts that corrupt PhilHealth officials and personnel knew about. These include cancer treatments for fictitious members, fake payments receipts of overseas workers as well as hospitals overcharging by declaring ailments like cough and common colds as harsher diseases like pneumonia. 

It is not only the dead who are affected by this scheme, but also the living as well. Stories of invalid Philhealth plans and benefit packages being invalid also surfaced. 

PRESIDENT DUTERTE: “TOTALLY, TOTALLY, UNACCEPTABLE

When the news broke out, President Rodrigo Duterte notes that he does not The President noted that he does “not have the slightest doubt about the integrity and honesty” of Philhealth chief Roy Ferrer, but losses of some P100 billion is “totally, totally unacceptable.”

He also noted that he intended to “reshuffle” the corporation.

“When I go back [to Manila], I’m making the announcement that I am maybe reshuffling the PhilHealth,” Duterte said in an interview on Pastor Apollo Quiboloy’s television show on Sonshine Media Network in Davao City. 

“For the sheer amount that was lost, I have to reorganize your entity, change maybe all of you and install a more — systems of accounting and accountability,” he said.

Image result for philippine ghost patients
via ABS-CBN News

The official statement from the Philippine Health Insurance Corp emphasized that the corporation does not “condone such acts as it undermines the people’s entitlement to one of their basic rights as human beings; the right to appropriate medical care.” 

In addition to this, they have filed 28 counts of administrative cases “for claims for non-admitted/treated patients; misrepresentation by furnishing false or incorrect information; and breach of warranties of accreditation/performance commitment against the mentioned dialysis center. Also, we have filed several counts of offenses against doctors for possible involvement between November and December 2018.

PhilHealth also encouraged the public to partake in the corporation’s efforts to combat fraud and to “take on the mantle of accountability and responsibility.”

“All of us must take on the mantle of accountability and responsibility in protecting the National Health Insurance Program (NHIP). We must confront the detractors that are poised to destroy the gains of PhilHealth. The program exists for the sick Filipinos needing appropriate medical attention; we should do everything in our power to keep it out of harm’s way.” -PIA, CNA, ABS CBN, TMT

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