Lifestyle

PhilHealth fraud: NBI sues 21 over WellMed approval

PhilHealth fraud: NBI sues 21 over WellMed approval

Twenty-one officials and employees of Philippine Health Insurance Corp. (PhilHealth) were charged in the Department of Justice on Wednesday for accrediting WellMed Dialysis and Laboratory Center despite an agency finding that the clinic had filed fraudulent claims for dead patients.

Recommended for prosecution were officials and employees of PhilHealth National Capital Region office’s accreditation subcommittee (ACS), according to the National Bureau of Investigation.

Names

They were Rizza Majella Herrera, Bernadette Lico, Janice Gem Perlas, Leilani Cherillina Joy Asprer, Rofien Ison, Manuel Lampitoc, Recto Panti, Henry Almanon, Jeffrey Pe, Cheryl Welan, Lolita Tuliao, Quentin Callueng, Mary Grace de los Santos, Maricel Maglalang, Susan Rebecca Romero, Yvonne Fernandez, Katrina Marie Aguilar, Cynthia Camacho, Imelda Trinidad de Vera-Pe, Arsenio Alcantara and Leticia Gay Aguda.

“These subjects are allegedly responsible in approving the accreditation of WellMed despite the 2019 Fact-Finding Investigation and Enforcement Department on the alleged fraudulent claims of WellMed,” said Vicente de Guzman, NBI deputy director for investigation.

P1.8 million

The NBI filed violations of Anti-Graft and Corrupt Practices Act, National Health Insurance Act, and the Code of Conduct and Ethical Standards for Public Officials and Employees against them.

WellMed was paid P1.8 million from January to May this year for the dialysis of patients who were already dead, according to the fact-finding unit of PhilHealth, which completed its probe in January.

WellMed was the subject of the Inquirer’s three-part investigative report which, among other things, found that PhilHealth lost tens of billions of pesos to overpayments and frauds committed over the past five years.

Not simple negligence

The NBI said the ACS had recommended the accreditation of WellMed on Jan. 4 but withdrew it on Feb. 7.

Still, the regional subcommittee processed the claims of WellMed on May 20.

“[This is] not just simple negligence. Despite the knowledge that they (WellMed management) have already fraudulent claims discovered by the fact-finding committee, WellMed was still given accreditation,” said Catherine Camposano-Remigio, the newly appointed antigraft division chief of the NBI.

Remigio said there was yet no evidence of PhilHealth employees being bribed to favor WellMed.

Undue benefit

“Based on the investigation, they [WellMed management] were given undue benefit out of the acts of the accreditation subcommittee,” said De Guzman.

The NBI has yet to uncover high-ranking officers involved in the WellMed ghost dialysis scam.

“Investigation is ongoing. We want to establish linkages of health care providers with some officers of PhilHealth,” De Guzman said.

The criminal charges against WellMed owner and officers were lodged in a Metropolitan Trial Court in Quezon City last week.

On Aug. 5, the Quezon City Regional Trial Court Branch 219 dismissed the estafa charges against WellMed owner Bryan Sy after the case was filed in the wrong court.