PhilHealth chief admits agency inefficiencies but no syndicate

MANILA, Philippines, June 23 ------ Philippine Health Insurance Corp. (PhilHealth) president and chief executive officer Ricardo Morales yesterday denied allegations that there are syndicates defrauding the agency. At a press briefing, Morales said that while there may be “inefficiencies” in their operations including in the processing of claims, there is no syndicate or “group of people colluding to defraud the corporation in that scale.”

“We are a very large corporation. Every day we process about 50,000 claims in 16 regional offices, about 120 branches, local health insurance offices. Some of them manually, some of them are not yet integrated. (Documents) are transferred manually, not yet automated,” he added. “Only a working, integrated and organized information system is going to solve a problem of this size,” he said. “Now, there is no healthcare system in the world that is fraud-free… But we can reduce the problem if we have perfectly integrated and harmonized information system but this is not going to happen overnight. It will take some time before coming into effect,” he said.

The official also reiterated there was no truth to reports that PhilHealth had lost some P154 billion to “ghost” patients. He disclosed that in a letter dated June 20, the Commission on Audit (COA) notified the state insurer of its not having found such losses in PhilHealth’s audited financial statements in the past five years. Morales added that COA had confirmed that the P154 billion also did not appear in the published COA Annual Audit Report on PhilHealth. COA initiated the special audit on Morales’ request shortly after he assumed office in 2019. Meanwhile, presidential spokesman Harry Roque denied that he is eyeing a post in PhilHealth, contrary to Morales’ claim.

“When it comes to PhilHealth, well General Morales said I’m interested. But that is demotion. I’m not interested,” Roque said at a press briefing. Roque said he won’t force Morales to join a meeting with President Duterte to discuss the issues surrounding the state health insurer. “Now that I know that he (Morales) does not want to attend a meeting, perhaps only those from PhilHealth who are willing to join the meeting will meet with the President,” he added.

Source: philstar.com