PhilHealth exec admits fraud costs P10B annually

PhilHealth President and CEO Ricardo Morales, who resigned on August 26, acknowledged that fraud is a significant issue within the corporation, citing a 2019 study that indicated an annual loss of P10 billion in 2019.

Morales stated that the corruption largely involves hospitals and professionals, suggesting that investigations should focus on collusion between these entities and PhilHealth officials.

He noted that fraud is a common problem in national health systems, with fraudulent benefit claimants attempting to obtain more than their due share, particularly through advance payments by healthcare providers.

These congressional probes have aimed to uncover the extent of these anomalies and identify those responsible within the state health insurer.

Among the alleged PhilHealth irregularities being looked into are the advance payment to hospitals and healthcare facilities, including those not dealing with COVID-19 patients, under the now-suspended Internal Reimbursement Mechanism (IRM); overpriced IT project and paying withholding tax using PhilHealth's operating fund, among others.