NBI releases owner of clinic tagged in dialysis scam

Maris Federez   •   June 17, 2019   •   1636

Dr. Bryan Sy, co-owner of WellMed Dialysis Center

The National Bureau of Investigation (NBI) on Sunday (June 16) released the co-owner of a dialysis center in Quezon City after being in detention for 6 days in connection with alleged fraudulent claims, his lawyer, Rowell Ilagan, said.

Dr. Bryan Sy, co-owner of WellMed Dialysis Center, was arrested on Monday (10) for allegedly ordering former employees to make claims for dialysis treatment from state-run Philippine Health Insurance Corp. (PhilHealth) on behalf of patients who had already died.

A Manila court on Saturday (June 15) ordered Sy’s release after his camp posted a P72,000 bail.

He was not, however, released immediately due to the absence of signatories from the NBI, said his lawyer.

Ilagan said Sy had to wait one more day and walked free from detention around 10:30 a.m. on Sunday.

The Department of Justice indicted Sy on June 14, along with former employees Edwin Roberto and Leizel Aileen de Leon, for estafa through falsification of official documents.

Roberto and De Leon jointly bared the alleged WellMed racket, revealing that it made P800,000 in ghost PhilHealth claims from 2016 to 2018.

WellMed lawyer, however, denied the ‘ghost claims’ with PhilHealth.

They wrote DOJ Secretary Menardo Guevarra and NBI Director Dante Gierran on Thursday to demand Sy’s release because his detention had exceeded 36 hours.

Under Article 125 of the Revised Penal Code, authorities have a maximum of 36 hours to detain a suspect without filing any charge in court. /mbmf

Criminal raps filed vs. 21 PhilHealth officials over ghost claims

Marje Pelayo   •   August 28, 2019

MANILA, Philippines – The National Bureau of Investigation (NBI) filed criminal charges against 21 officials of Philippine Health Insurance Corporation (PhilHealth) on Wednesday (August 28).

All accused belong to PhilHealth’s accreditation division.

The complaint stemmed from the official’s alleged negligence of work and conspiracy which resulted in ghost claims at WellMed Dialysis Center, according to NBI Deputy Director for Investigation Service Vicente de Guzman III based on their initial investigation.

De Guzman said the center’s record revealed that claims were still processed using names of deceased patients.

Base sa imbestigasyon ng ating anti graft (unit), it appears na nagkaroon sila ng [sabwatan] (Based on the investigation of our anti-graft (unit), there was conspiracy) because they are given undue benefits out of the acts of the accreditation committee,” he said.

Atty. Ferdinand Razon, the NBI agent handling the case, said Wellmed was able to receive a total of P1.8 million worth of PhilHealth claims in between January and May 2019.

Investigation is ongoing to be able to identify other personalities involved in the scam, De Guzman said.

“We are still tracking that but we cannot categorically say na meron kaya po ang imbestigasyon ng NBI ay patuloy, (that there are [other people involved] that’s why our investigation is ongoing),” he noted.

“We want to establish kung mayroong (if there are) linkages itong mga (between the) health care providers with some officers of PhilHeath,” he added.

The concerned PhilHealth officials were charged for violation of the Anti Graft and Corrupt Practices Act, National Health Insurance Act of 2013 and the Code of Conduct and Ethical Standards for Public Officials and Employees.

In June this year, the state-owned insurance corporation filed a case against Wellmed Dialysis Center and its owner, Bryan Christopher Sy, over the said ghost claims. – MNP (with details from Lea Ylagan)

Privatization, case rate payment scheme removal, recommended amid PhilHealth anomaly issue

Maris Federez   •   August 14, 2019

Senator Franklin Drilon at Wednesday’s (August 13) hearing of the Senate Blue Ribbon Committee expressed concern on the Philippine Health Insurance Corporation’s ability to pay its members the necessary claims and benefits in the next ten years.

“I do not know how to sustain these in the next 10 years if you keep on incurring a net operating cost. At the end of the day, you might see a collapsing Philhealth,” Drilon said.

This is after the Commission on Audit (COA) released its report of the state insurance’s yearly net operating loss that has now reached billions of pesos.

To which Philhealth vice president for Data Protection, Nerissa Santiago answered: “Those were the years that we increased the benefits without the increase in premiums.”

Other senators were also alarmed by the alleged anomaly and corruption in the agency, including overpayment and ghost dialysis patients.

With this, former Department of Health (DOH) secretary and now Iloilo representative Janette Garin recommended the abolition of the case rate payment scheme and the privatization of some of the operations of the state insurance.

This, she said, will help eradicate corruption.

“Scrap the case rate case. Push through with the individual membership on smaller premium para mawala po ang [so that we will eliminate] ghost members,” Garin said. (from the report of Nel Maribojoc) /mbmf

Blue Ribbon invites Philhealth officials in hearing on state insurance anomaly

Maris Federez   •   August 6, 2019

Senator Panfilo Lacson

The Senate Blue Ribbon Committee has set its hearing on the alleged anomaly in the Philippine Health Insurance Corporation (Philhealth) on Thursday (August 8).

In his privilege speech, Senator Panfilo Lacson revealed that Php153-Billion of Philhealth’s fund had gone to overpayments and fraud.

Lacson added that he had requested to send invitations to several Philhealth officials who can testify to the alleged anomaly in the state insurance agency.

“Mga regional senior vice presidents kasi [These are regional senior vice presidents because] many of the information that we got came from insiders from Philhealth themselves,” Lacson said.  (with details from Nel Maribojoc) /mbmf

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