(Eagle News)–The people who were supposed to set the policies and operational guidelines for the management of PhilHealth did not show the due diligence required of them in the discharge of their duties.
This was among the findings of the Department of Justice-led task force that probed the allegations of corruption in the state insurer, and which submitted a report of its recommendations to President Rodrigo Duterte on Monday.
Also on Monday, the President approved the filing of charges against former PhilHealth chief Ricardo Morales and others over the allegations made by Thorrsson Montes Keith, who resigned as PhilHealth anti-fraud officer.
The task force particularly flagged PhilHealth’s Board of Directors and Executive Committee in its probe that focused on the Interim Reimbursement Mechanism, the PhilHealth-proposed P2-billion ICT system, and corporate policies.
IRM
With regard to the IRM, the task force said the executive committee and the board were negligent as IRM releases were rushed even if the circular implementing the scheme was not effective.
The task force said the board issued the circular making the IRM a “special privilege” on January 30, 2020, which meant funds could be made available every time a fortuitous event would arise.
The task force also noted that the IRM was implemented without sufficient standards and guidelines, making fund releases prone to abuse, and that IRM fund releases were made despite the absence of mechanisms to monitor fund utilization and liquidation, and without taxes due being withheld.
Proposed ICT equipment
As for the proposed ICT equipment, the task force said it found that members of the executive committee purposely withheld the presentation of important information or audit documents to obtain the board’s approval on their requested budget allocations for the ICT equipment.
According to the task force, in one instance, a request of over P730 million was made even if this was not included in the corporation’s Information System Strategic Plan as required by law.
The task force added an internal audit report that detailed what it said were major discrepancies or inconsistencies in the inventory of the corporation’s hardware or software, and in the appraisal of certain documents supporting its ICT expenditures was also not presented.
A proposal to procure network switches for the PhilHealth-NCR office was also recommended to and approved by the board, notwithstanding the existence of a Commission on Audit memorandum on the non-utilization of 24 similar switches.
Corporate policies
The task force also flagged what it said was PhilHealth’s policy toward a settlement of claims without accountability, and the grant of wholesale amnesty in favor of healthcare institutions with claims that appear to no longer be enforceable against PhilHealth.
It also flagged PhilHealth’s settlement of cases involving fictitious crediting of remittances, where contributions, the task force said, were diverted to a private account, or where payment to a healthcare institution was diverted to an undisclosed account.
In at least six occasions, the task force also noted that penalty of suspension against erring healthcare institutions, even if affirmed in a final judgment by either the Court of Appeals or the Supreme Court, was changed to a mere payment of fines.
In at least 20 instances, the board also withheld the penalty of suspension and dispensed with the filing of appropriate legal action against erring healthcare institutions in exchange for a payment of fines instead, the task force said.
According to the task force, while the board was negligent in some of its decisions, this was “mitigated by the active concealment of vital documents and by the apparent misrepresentation by those who sought the board’s approval.”
It recommended that President Duterte “strongly admonish and remind the Chairman (Health Secretary Francisco Duque III) and Members of the Board of the grave consequences of their action or inaction.”
Apart from Morales, the task force recommended the filing of criminal charges against the following:
1. Executive Vice President and Chief Operating Officer Arnel De Jesus for violation of Section 3(e) of RA No. 3019;
2. Senior Vice President Jovita V. Aragona, Chief Information Officer and Head of the Information Management Sector, for: violation of Sections 3(a), (e), (g) of RA No. 3019; Frauds against the public treasury and similar offenses under the Revised Penal Code;
3. Senior Vice President Renato Limsiaco, Jr. for: violation of Section 3(e) of RA No. 3019; and Malversation of Public Funds or Property under the Revised Penal Code;
4. Senior Vice President Israel Francis A. Pargas of the Health Financial Policy Sector for: violation of Section 3(e) of RA No. 3019;
5. Officer in Charge Calixto Gabuya, Jr. for: violation of Sections 3(e), (g) of RA No. 3019; and Frauds against the public treasury and similar offenses under the Revised Penal Code; and
6. Division Chief Bobby A. Crisostomo for violation of Section 3(a) of RA No. 3019.
The task force also recommended the filing of administrative charges for dishonesty, gross neglect of duty, grave misconduct, and conduct prejudicial to the best interest of the service, among others, against these individuals.