A ‘ghost dialysis’ controversy is shaking up the Philippines’ health insurance agency

WellMed Dialysis Center allegedly charged the government for treatments even after the deaths of its patients. Photo: ABS-CBN News
WellMed Dialysis Center allegedly charged the government for treatments even after the deaths of its patients. Photo: ABS-CBN News

Top officials from the Philippine Health Insurance Corporation (PhilHealth) are expected to resign from their posts today after Philippine President Rodrigo Duterte urged them to quit, following a “ghost dialysis” controversy that has shaken up the government-owned agency.

Duterte has told PhilHealth’s acting president Dr. Roy Ferrer and the organization’s board members to resign because of the issue, reported Rappler. 

A scandal erupted on Thursday last week when The Philippine Daily Inquirer published an exposé where two former employees of WellMed Dialysis & Laboratory Center Corporation named Edwin Roberto and Liezel Santos said that the lab continued charging the PhilHealth for the dialysis treatment of patients even if they were already dead. Roberto called the practice “ghost dialysis.”

PhilHealth is a government-owned insurance corporation that provides healthcare to citizens.

Roberto and Santos had first-hand knowledge of the alleged scam because they said the owners of WellMed allegedly instructed them to file the fraudulent claims. They reported the anomaly to PhilHealth last year but they said the agency is slow in addressing the case. They also alleged that they were receiving threats from WellMed’s owner and that PhilHealth couldn’t provide them protection.

The newspaper also reported that PhilHealth has been losing a total of PHP154 billion (US$2.996 billion) since 2013 because it was blindly overpaying hospitals for patients’ treatments. Minguita Padilla, the former head executive staff of former Health Secretary Janette Garin, said hospitals managed to overcharge PhilHealth because there were people working in the insurance corporation who protected these health providers.

On Monday, the National Bureau of Investigation (NBI) arrested Roberto and Santos, who were both charged with fraud and falsification of documents today. NBI spokesman Ferdinand Lavin told CNN Philippines that they needed to charge the whistleblowers first before they could be turned into state witnesses.

The NBI also arrested the owner of WellMed Bryan Sy yesterday without a warrant of arrest when he visited the bureau’s office after he was subpoenaed. He was presented by the NBI before the Manila Regional Trial Court Branch 20 for his inquest proceedings today for charges of fraud through falsification of public documents and violation of the PhilHealth’s laws, reported Manila Bulletin.

Bryan’s wife Therese Francesca Tan-Sy has questioned the validity of his arrest.

The forced resignation of PhilHealth officials follows Duterte’s vow on Saturday during a Facebook video interview with his friend Pastor Apollo Quiboloy that he would “change” all of the agency’s officers even if he didn’t have proof that they were in cahoots with hospitals and other health care providers in overcharging the PhilHealth for patients’ treatments.

The NBI announced today that they will also file fraud and falsification charges against officers of PhilHealth in connection to the case, but did not name who these people were.

Duterte’s former assistant Senator Christopher “Bong” Go said today that the president will tap a certain Dr. Jaime Cruz to head PhilHealth. Cruz is a board member of the Philippine Chinese Charitable Association Incorporated, which manages the Chinese General Hospital and Medical Center in Sampaloc, Manila. He is also the chief executive officer of the JTC Group of Companies, which owns Dohtonbori restaurant.

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