Philhealth under fire amid reports of fraudulent claims
MEDICAL inflation in the Philippines is on the rise this year, surging to 13.7% from 2018’s 13% making it the second highest increase in the Asia-Pacific region, a recent study found.
According to the “2019 Medical Trends Around The World,” the rise in Philippine healthcare cost is much higher than the 5.2 percent increase in the prices of goods and services for the whole of 2018.
The study was conducted by Mercer Marsh Benefits, an international employee benefits consultancy. The firm surveyed 204 insurers across 59 countries, and assessed how health conditions, supplier factors and consumer habits are driving cost.
The highest medical inflation rate in the region belongs to Vietnam, with 14.2 percent; meanwhile, Malaysia is third with 13.6 percent.
The report said that the global average is 9.7%, excluding the United States because of its unique healthcare system.
The study also showed that the high cost of pharmaceuticals, new diagnostics and procedures, and overprescribing of low-value health tests and procedures are the primary drivers of high medical inflation on the supplier side.
Meanwhile, the top health risk factors influencing medical cost are metabolic and cardiovascular risk, dietary risk, and emotional/mental risk.
In the Philippines, hospitals and clinics that have been defrauding the Philippine Health Insurance Corporation (PhilHealth) through bogus claims are being probed by the National Bureau of Investigation (NBI).
According to the NBI, WellMed’s involvement in the ghost dialysis scam is just the tip of the iceberg.
WellMed, owned by Bryan Christopher Sy, allegedly filed benefit claims for patients who had already died, earning more than P800,000 through it.
However, the NBI said other medical facilities were doing a similar scheme and were earning more.
“As of now, in order not to compromise the operations being conducted by our agents we beg not to disclose yet the institutions as well as personalities,” said NBI spokesperson Ferdinand Lavin on Thursday, June 13.
Deputy Director for Investigation Jun de Guzman, meanwhile, said that after filing a case against Sy, the NBI’s next step is to identify the people in PhilHealth who made the scam possible.
Sy, who is currently detained at the bureau after a Manila court denied his petition questioning his detention, faces estafa through falsification of documents after the NBI found probable cause that WellMed filed claims for dead PhilHealth members.
Executive officers and board members of PhilHealth have tendered their courtesy resignation, Malacañang confirmed on Thursday.
According to PhilHealth deputy spokesperson Rey Balena, acting PhilHealth President and Chief Executive Officer Roy Ferrer filed his resignation effective on Tuesday night as well as board members Jack Arroyo, elected Local Chief Executive; Rex Maria Mendoza, Independent Director of the Monetary Board; Hildegardes Dineros, Representative of the Informal Economy Sector; Roberto Salvador, Formal Economy Sector; Joan Cristine Reina Liban-Lareza, Healthcare Provider Sector; and Former PhilHealth chief Celestina dela Serna of the Filipino Overseas Workers Sector.
“Our Office of the Chair of the PhilHealth Board confirms that Dr. Ferrer and all six board members tendered their resignation on June 11,” Balena said.
“It is up to Malacañang now if they will accept the resignation,” he added.
PhilHealth executive vice president John Basa will serve as the officer-in-charge of the agency, said Health Secretary Francisco Duque III.