PhilHealth probing 8,000 fraud cases
Credit to Author: Tempo Desk| Date: Fri, 07 Jun 2019 09:25:13 +0000
The Philippine Health Insurance Corp. said yesterday that it is investigating more than 8,000 cases of fraudulent activities committed by some of its partner health institutions.
PhilHealth spokersperson Dr. Shirley Domingo said that the alleged “ghost dialysis” scheme of WellMed Dialysis and Laboratory Center is not an isolated case.
“Hindi po isolated case ito. Our records show that currently we are investigating up to 8,900 plus cases that is pending in our investigation department,” Domingo said in a television interview yesterday.
Domingo said that the fraudulent activities that they are currently investigating include “ghost patients,” false claims, misrepresentation, and upcasing in which “minsan ubo lang gagawin pneumonia.”
The alleged ghost dialysis scheme of the Quezon City-based medical facility was bared by its two former employees, who said that the medical institution has been filing claims for dialysis sessions on behalf of their patients who have died.
“PhilHealth 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,” said PhilHealth acting president and chief executive officer Dr. Roy Ferrer.
“In relation to this case, the corporation has filed 28 counts of administrative cases of 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,” he added.
Ferrer also vowed to fasttrack the resolution of such fraudulent cases. “Our Board of Directors has approved the hiring of additional human resource to ensure speedy identification and resolution of cases,” he said. (Analou de Vera)