Duterte Wants Philippine Health Insurance Probed Over Bogus Dialysis Payments

Philippine Health Insurance Corp allegedly paid for the dialysis of dead patients.

KUALA LUMPUR, June 10 – Philippine President Rodrigo Duterte has instructed the country’s state-owned national health insurance company to act on allegations that it approved payments for the dialysis of dead patients.

The Manila Times reported that former employees of the WellMed Dialysis & Laboratory Centre Corp claimed that Philippine Health Insurance Corp (PhilHealth) had continued paying for the dialysis of patients who had already died.

“The President directs the management of the PhilHealth to institute criminal actions against those officials and employees who wittingly or unwittingly allowed such misuse of funds to take place for years,” Palace spokesman Salvador Panelo was quoted saying in a statement.

Acting PhilHealth president and CEO Roy Ferrer reportedly said that the corporation has filed 28 counts of administrative claims for non-admitted treated patients, misrepresentations by furnishing false or incorrect information, and breach of warranties of accreditations performance against WellMed.

“Also, we have filed several counts of offences against doctors for possible involvement between November and December 2018,” he was quoted saying.

WellMed has reportedly denied the allegation.

Philippine Daily Inquirer reported former WellMed employee Edwin Roberto as saying in an affidavit that Wellmed exploited a loophole in PhilHealth’s reporting system on patients’ death, as PhilHealth depended on hospitals or clinics to report the death of patients who received treatment covered by the national health insurance programme.

He alleged that WellMed initially tried in 2016 to collect PhilHealth benefit payments for four patients who had died, while his affidavit listed an additional eight dead patients whose names WellMed allegedly used in the so-called scheme.

WellMed “vehemently” denied the accusations and claimed that Roberto and another ex-employee, Liezel Santos, were the ones who had perpetrated the fraud, saying it would file criminal charges against the duo.

All Filipino citizens are automatically enrolled in the country’s national health insurance programme after it was legislated last February.

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