Officials of the Philippine Health Insurance Corp. as well as hospitals are facing complaints filed by the National Bureau of Investigation before the Office of the Ombudsman in connection with supposed misuse of the Interim Reimbursement Mechanism (IRM) for cases in 2018.
The NBI-Dagupan District Office sued 20 PhilHealth officials and hospitals in the Ilocos region on the orders of NBI chief Eric Distor.
Included in the complaints were ex-PhilHealth President and chief executive officer Ricardo Morale, five officers from PhilHealth’s main office, and five others from the region – ex-regional vice president Alberto Manduriao, Healthcare Management Division chief, former and current Fiscal Controller chief of Fund Management Section, and the senior social insurance officer.
As early as July, the NBI filed complaints against Region 1’s Balaoan District Hospital, Blessed Family Doctors Hospital, Caba District Hospital, Candon St. Martin de Porres Hospital, Corpuz Clinic and Hospital, Dr. Bonifacia V. Albano Memorial Hospital, Elguira General Hospital, Gaoat General Hospital, Gov. Roque B. Ablan Sr.Memorial Hospital; Ilocos Sur District Hospital-Magsingal, Jesus Nazarene General Hospital, Judge Celestino Guerrero Memorial Hospital, La Union Medical Center, La Union Medical Diagnostic Center and Hospital, Lorma Medical Center, Mariano Marcos Memorial Hospital and Medical Center, Nuestro Señor Santo Niño Hospital, Pangasinan Doctors Hospital, Pira Hospital; Socony Medical Group, Sta. Teresita Hospital, Sto. Cristo Milagroso Hospital, Sto. Niño Hospital and Tayug Family Hospital.
The respondents allegedly violated Section 44 of Republic Act 10606 or the National Health Insurance Act of 2013, Section 3 (e), (g), and (j) of Republic Act 3019 or the Anti-Graft and Corrupt Practices Act, and committed administrative cases of grave misconduct, gross dishonesty, gross negligence, conduct prejudicial to best interest of service and technical malversation.
The NBI accused them of improper utilization of PhilHealth’s IRM, the program handling emergency cash advances for medical facilities during “fortuitous events.”
The COVID-19 pandemic hit the country in March 2020. But according to NBI-DADO chief Rizaldy Jaymalin, several hospitals applied the IRMs for cases that happened in 2018 and 2019.
