MANILA, Philippines – Health Secretary Francisco Duque III is looking to revamp the accreditation unit of the Philippine Health Insurance Corp. (Philhealth) in relation to the “ghost dialysis” controversy.
At a press briefing on Tuesday, Duque questioned the committee for its alleged inaction on the recommendation to revoke the accreditation of WellMed Dialysis Center, the facility being linked to the issue.
The Health official said they have already identified the members of the accreditation unit who may have committed negligence with regard to the controversy.
“It is the accreditation committee where we think nagkaroon talaga ng oversight. That is the subject of the ongoing investigation,” he said.
Duque added that they are also looking into other operating committees within the Philhealth Central office that might also be involved in the multi-million ‘ghost dialysis’ claims issue.
“There is a possibility of connivance, I think, because it’s hard to believe that this will just be happening without somebody from the inside who knows how to circumvent, how to go around the processes of Philhealth,” he said.
Duque also directed Philhealth to identify which among the more than 7,000 claims made in 2018 may be considered as anomalous or fraudulent.
He also ordered for the list of hospitals and other medical facilities that might have asked Philhealth for dialysis payments of already deceased patients.
“I have instructed Philhealth to identify for 2018 7, 213 cases have been filed and how many of those cases account for ghost claims. Kasi marami tayong fraudulent claims, meron tayong multiple filing of claims,” Duque said.
“So ito, talamak din po ito. Ito pong ating mga inappropriate treatment or procedures being done na hindi sang-ayon sa clinical practice guidelines,” he added.
On Monday, President Rodrigo Duterte asked for the courtesy resignation of some Philhealth officials amid the ongoing investigation into the controversy.
Duque said the President expects them to tender their resignation within Tuesday.
However, the health official said he will seek to clarify with the President on who among these executives have been instructed to resign in line with the chief executive’s order to allow the state-run firm to start on a clean slate.
He added that Philhealth officials will have to stay until their resignation letters are formally accepted by the Office of the President. (with details from Aiko Miguel)