Task force flags PhilHealth over slow and low processing rate of cases
Task Force PhilHealth has flagged the low and slow rate of prosecution of cases by the Legal Sector of the Philippine Health Insurance Corporation (PhilHealth).
In its hearing conducted yesterday, the Task Force noted the thousands of cases against erring PhilHealth employees and health care institutions (HCIs) which remain unfiled.
Resigned Senior Vice President for the Legal Sector Atty. Rodolfo Del Rosario, Jr. confirmed that while there are thousands of administrative cases against PhilHealth employees in the corporation’s case inventory, only seventy (70) cases have been ‘processed,’ and only fifty (50) have resulted in the issuance of formal charges against employees. He noted a case against PhilHealth employees that allegedly involve around P2.1B.
Del Rosario likewise reported that there are around 1,700 cases in PhilHealth’s case inventory involving HCIs. According to him, his office has reviewed and endorsed 1,003 cases for filing of criminal complaints by the regional offices. However, he admitted that only 11 cases as of date have been filed. Losses related to cases involving HCIs — which include fraudulent claims — were estimated at around P4.7B.
The Governance Commission for Government-Owned and -Controlled Corporations has previously given the PhilHealth Legal Sector zero rating in its 2017 and 2018 evaluations because of delays in the filing of cases.
Pressed to account for the Legal Sector’s performance, Del Rosario explained that management policy favored settlement over prosecution of cases so as not to dampen esprit de corps. He also noted alleged limitations in resources of regional offices that prevent them from promptly filing criminal complaints against HCIs.
The Task Force has earlier created a composite team that will investigate PhilHealth’s Legal Department. The team will, among others, audit and validate the case inventory of PhilHealth, and recommend, if warranted, the commencement of administrative, civil and/or criminal action against the corporation’s employees and HCIs.— Source: ptvnews.ph