Members of alleged PhilHealth ‘mafia’ named

By Xave Gregorio, CNN Philippines

A former official of the Philippine Health Insurance Corp. (PhilHealth) on Wednesday bared the names of the members of the alleged “mafia” in the state health insurer.

On the prodding of Senate Minority Leader Franklin Drilon during a Senate probe on purported anomalies in the agency, former PhilHealth board member Roberto Salvador named five regional vice presidents and a sacked regional vice president as alleged members of the supposed mafia:

PhilHealth Vice President for Region IV-B Paolo Johann Perez

PhilHealth Vice President for Region VII William Chavez

PhilHealth Vice President for Region X Masiding Alonto Jr.

PhilHealth Vice President for Region XII Dennis Adre

PhilHealth Vice President for ARMM Khaliquzzaman Macabato

Former PhilHealth Vice President for Region XII Miriam Grace Pamonag

Salvador also alleged that PhilHealth’s assistant corporate secretary, Valerie Hollero, and its legal officer, Jelbert Calicto, are part of the group, dubbed as the “Mindanao bloc.”

He said the PhilHealth board has slapped most of them with administrative charges, which caused their preventive suspensions.

Alonto was also supposed to face a complaint for allegedly extorting from a hospital, but the witness in the case withdrew, Salvador said.

Despite these charges, Salvador was quick to caution that even if they are calling them a mafia, the officials are not necessarily extorting from anyone. Reading from a dictionary on his phone, he said they are just a “closed group of people in a particular field, having a controlling influence.”

He said they always resisted being transferred to another area.

Kaya tinawag naming [That’s why we called them] mafia kasi [because] they will call their friends and harass the current administration,” Salvador said.

He explained that most of these regional vice presidents were assigned in areas where many health institutions were suspected of making fraudulent claims for cataract and sepsis treatments.

Madali sanang ma-detect ang fraud if the [regional vice president] is functioning,” Salvador said.

[Translation: Fraud would be easily detected if the regional vice president is functioning.]

Former PhilHealth President Roy Ferrer had already hinted at a mafia operating in PhilHealth when a massive insurance fraud scandal involving WellMed Disalysis Center was exposed. He said a mafia is targeting him because of his focus against fraud.

Members of the group, who were present at the hearing, were quick to defend themselves — even turning the tables on their accusers, Salvador and Ferrer.

Hollero said Pamonag recommended the non-accreditation of South Cotabato neurologist Mark Menguita of St. Louis Hospital, but this was overturned by Ferrer. Senate President Vicente “Tito” Sotto III accused Menguita of collecting PhilHealth claims fraudulently during the deliberations on the PhilHealth’s 2019 budget.

Pamonag was then appealing her dismissal for asking then-PhilHealth acting CEO Ramon Aristosa to release of PhilHealth Region XII’s Christmas bonus, Hollero said.

She said Pamonag wrote to Ferrer to ask about the parameters she should use in accrediting doctors in the future, after her refusal to accredit Menguita was overturned. The next day, her appeal was denied and she was sacked, Hollero claimed.

“We are standing for the truth. If we are gonna be called mafia for it, then so be it,” Hollero said.

The members of the Mindanao bloc in PhilHealth claimed that they are being targeted because of their “anti-fraud crusade.”

Most of them said they faced “absurd” administrative charges one after the other, causing some of them to be suspended for up to nine months. These complaints were initiated by Ferrer and Salvador, they said.

Salvador and Ferrer were no longer able to answer these accusations during the hearing due to lack of time.

Senate Blue Ribbon committee chair Richard “Dick” Gordon asked the members of the supposed mafia, along with Ferrer and Salvador, to submit more documents to the panel. Another hearing is set on August 27.

Congressional probes have been conducted following the revelation of a massive insurance fraud involving WellMed Dialysis Center, which supposedly profited off the state health insurer by making fake claims for dialysis patients who were already dead.

This, on top of PhilHealth losing billions in net operating expenses, leaving lawmakers concerned whether the state health insurer could even handle the full implementation of the Universal Health Care law.

Hindi natin pwedeng hayaan na mabangkarote ang PhilHealth. Hindi mababangkarote ang PhilHealth, ang mababangkarote ang tao. Walang tatakbuhan ang tao pagka sila ay nagkasakit,” Gordon said.

[Translation: We cannot let PhilHealth go bankrupt. PhilHealth won’t be bankrupt, the people will. They would have no one to turn to if they get sick.]

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