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Covid-19 claims given in advance to hosps
By: Vanessa Almeda | Published Wednesday, February 10, 2021
Photo from Sugbo News

Hospitals already have the funds for Covid-19 cases from the Philippine Health Insurance Corporation (PhilHealth) as “cash advance” even before patients can claim benefits.

Gov. Gwendolyn Garcia believes this prompted the connivance of certain officials of the government-run insurance facility and private hospitals.

“Daghan naman na nga kaso. Incentivized na ning Covid, advance gud ni ihatag. Ila na i-liquidate aron makadawat na pud sa sunod na tranche mao na paspasay ang pag-claim sa Covid,” the governor said in a press conference Tuesday, February 9 at the Capitol.

To recall, Garcia was the first to bring to public attention reports of corruption involving Philhealth officials and hospital executives using public funds for Covid-19 claims.

Garcia had since disclosed cases of irregularity in Philhealth Covid-19 claims explaining that because of the pandemic, releasing of Philhealth funds to hospitals were paid in advance or what she calls the “incentivization of Covid-19.”

Here, Covid-19 cases are categorized as mild, middle and severe starting from P60,000 to P75,000 for mild or “suspected” cases to as high as P750,000 for severe or critical cases.

She said because of the pandemic, Philhealth, which usually reimburses claims to hospitals after the admission, now downloads the money to hospitals in advance. The hospitals will just need to liquidate these funds and once this is liquidated, a new tranche will be downloaded.

In the case of her brothers, former Dumanjug Mayor Nelson Garcia and Barili Mayor Marlon Garcia, they were billed to a staggering P5 million and P3 million, respectively.

The Garcia family was also surprised to learn of a Philhealth claim reimbursement for 16 doctors when only three attended to Marlon.

The governor found this as another “modus” of the anomalous claim scheme.

Garcia lauded the courage and patriotism of the National Bureau of Investigation (NBI) in filing a case against Philhealth and Chong Hua Hospital (CHH).

“That is just the tip of the iceberg and I hope the NBI will continue its investigation,” she said.

On Monday, February 8, the NBI filed graft and malversation of funds charges against several PhilHealth officials and three CHH officials for alleged fraudulent claims.

The NBI said CHH filed for a Covid-19 claim amounting to P193,000 for one of its patient whom they allegedly declared a frontliner.

NBI-7 Special Agent Arnel Pura said based on their investigation, the hospital made it appear that the patient died of Covid-19 when in fact, the patient had been in and outside of the hospital because of a kidney problem. 

The patient was admitted last March 30 and died of kidney failure, the NBI found out in its investigation. 

The NBI filed alleged malversation of public funds through falsification of documents and violation of RA No. 3019 or the Anti-Graft and Practices Act at the Office of the Ombudsman. 

This is the second case filed against the private hospital for fraudulent Philhealth claims. 

Last year, the governor and her family filed cases against CHH and its doctors of medical negligence for the death of her brothers. 

The governor said this is just the start of the several anomalies that will soon come out involving the state-run health insurance corporation.

“More investigation will uncover a Pandora’s box. Mangabuking ning mga ospital,” Garcia said.

“It is patriotism. Kay unsa man? This is robbing the national government. Kawat man ni harap-harapan. Kan kinsa man pud ni kwarta? Taxes pud na nato. Inyo nang mga contribution, ato nang mga contribution sa Philhealth,” the governor said. (Vanessa L. Almeda)