Manila Bulletin
'PhilHealth IT systems can't detect fraud'
A Philippine Health Insurance Corp. (PhilHealth) official revealed that the state insurer's current IT systems cannot detect fraudulent claims, according to the Department of Justice (DOJ).
Senior Vice President Jovita Aragona informed Task Force PhilHealth that some validation processes are still manual.
Aragona also stated that relevant offices failed to specify their required internal control systems during the IT system's development.
PhilHealth plans to develop more sophisticated IT systems in the future to combat corruption.
The corporation is currently investigating approximately 20,000 fraudulent claims.
Task Force PhilHealth has formed teams to thoroughly investigate the IT and legal sectors of PhilHealth.
Aragona called for an investigation into PhilHealth's National Capital Region Office regarding an allegedly anomalous procurement of network switches.
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News Sources
See how different news organizations are covering this story. Below are the original articles from various Philippine news sources that contributed to this summary.
Two anonymous whistleblowers have exposed fraudulent schemes perpetrated by PhilHealth officers and employees during the initial investigative hearing of the Department of Justice's Task Force PhilHealth.
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The DOJ's Task Force PhilHealth has flagged the "low and slow" prosecution rate of cases against erring PhilHealth employees and healthcare institutions (HCIs).
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PhilHealth lost at least P2 billion due to fraud in its Interim Reimbursement Mechanism (IRM) program, which distributed over P14 billion to hospitals for COVID-19 operations.
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A government task force investigating alleged corruption at PhilHealth has recommended the formation of an interim management committee to oversee the state insurer's operations during the ongoing probe.
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House committees investigating PhilHealth have summoned officials from 45 hospitals implicated in fraud cases with the state health insurer.
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