Press Release
August 6, 2019

De Lima seeks probe into alleged corruption, mismanagement in PhilHealth

Senator Leila M. de Lima has expressed alarm over the alleged widespread corruption and mismanagement in the Philippine Health Insurance Corp. (PhilHealth) which resulted in the depletion of its funds intended for its programs for its members.

De Lima filed Senate Resolution (SR) No. 62 urging the appropriate Senate committee to investigate the alleged corruption and inefficiency in PhilHealth that led to operational losses amounting to ?154 billion since 2013, to date.

"PhilHealth cannot continue operating with this level of corruption and incompetence lest they continue to incur losses which will continue to prejudice our national health services to the detriment of our countrymen," she said.

Based on the Commission on Audit (COA) report, PhilHealth has incurred a net loss of ?4.75 billion for 2017 which led to its poor implementation of programs and projects for its more than 77 million members nationwide.

The same report also claimed that PhilHealth continues to face serious leakages and operation losses amounting to ?154 billion since 2013. Of said reported "losses" in the past six years, ?102.5 billion was due to overpayment.

De Lima, who chairs the Senate Committee on Social Justice, Welfare and Rural Development, also cited several reports of anomalies and widespread corruption haunting PhilHealth personnel and officers in the past years.

For one, she noted the overpayment of PhilHealth that depletes its funds, notably its upcasing problems where there were questionable claims for pneumonia cases even if patients had only cough or cold, and for other overpayments for medical procedures.

According to her, COA also uncovered illegal bonuses and perks to various PhilHealth officials and offices. In 2018, COA found that PhilHealth distributed ?164 million in unauthorized perks to officials and personnel in 2009, 2010, and 2014. "It was also widely reported that PhilHealth was involved in falsified claims for payment for dialysis treatments, as in the case of WellMed Dialysis & Laboratory Center Corp (WellMed)," she added.

The lady Senator from Bicol underscored the urgency to stop the widespread corruption and mismanagement of PhilHealth as it is the primary institution involved in the implementation of the National Health Insurance and Universal Health Care programs.

"It is imperative that government continues to deliver an effective health insurance program and social protection mitigating mechanisms helping individuals and their households reduce the impact of future risky events, such as illnesses, especially for the marginalized and vulnerable members of society," she said.

She also underscored the need to determine the root causes of the incurred losses and provide policy and structural reforms while ensuring accountability of the PhilHealth leadership in all levels.

"There is need to determine and address the root causes of the incurred losses, provide policy and structural reforms, as well as the possible accountability of the PhilHealth leadership in all levels," she added.

De Lima said the Senate investigation should help establish a clear roadmap towards financial stability, transparency and higher accountability to ensure that PhilHealth will be able to provide credible and reliable services to its members.

The alleged massive corruption in the PhilHealth, such as the purported payment scam, was also the subject of Sen. Panfilo M. Lacson's privilege speech at the Senate last July 29.

In the 17th Congress, De Lima filed SR No. 840 seeking a Senate investigation into PhilHealth's poor financial performance and its sustainability to fulfill its mandated services to the public after the agency incurred ?4.75 billion net loss in 2017 alone.

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