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Philhealth says hospitals main sources of fraud

Philippine Health Insurance Corporation (PhilHealth) President and CEO Ricardo Morales on August 10 said that hospitals are the ones involved in massive fraud, Manila Bulletin reported.

Amid the allegations of massive corruption among PhilHealth’s top officials, Morales said it is the hospitals that are conducting fraudulent schemes in their offices.

“So we are alerting the regional offices to go after these hospitals and to see to it that this is corrected and anybody guilty should be punished,” he said during an interview with CNN Philippines.

He added that there are about 20,000 cases of potential fraud in the corporation’s legal offices.

“About 8,000 here in the central office and about 12,000 in the regions, equivalent to ₱4.5-billion of potential fraud,” the President stressed.

Morales also underscored that a study of PhilHealth in December 2019 showed that its fraud index is at 7.5 percent, adding that of the PHP136 billion benefit payments made last year, about PHP10 billion of that was fraud.

“So, in other words, for every peso spent, about 7.5 centavos goes to fraud,” he added. “Where is this fraud? Most probably in the hospitals.”

The agency’s chief also said that hospitals are charging coronavirus disease (COVID-19) rates for non-COVID-19 cases.

Amid the agency being in hot water due to corruption allegations, Morales said he will not resign because he is not guilty and that “changing horses in the middle of the stream” is “not wise.”

“I welcome it. I have nothing to hide. I might be embarrassed, but I have nothing to hide. I have already relayed to my bosses my intentions, and it’s up to them to decide,” he said, adding that it is up to President Duterte to retain or let him go.

Staff Report

The Filipino Times is the chronicler of stories for, of and by Filipinos all over the world, reaching more than 236 countries in readership. Any interesting story to share? Email us at [email protected]

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