Republic of the Philippines HOUSE OF REPRESENTATIVES Quezon City EIGHTEENTH CONGRESS Second Regular Session 1069 House Resolution No, Introduced by ANAKALUSUGAN PARTY-LIST REPRESENTATIVE MICHAEL T. DEFENSOR: RESOLUTION CALLING FOR A MOTU PROPRIO INVESTIGATION IN AID OF LEGISLATION BY THE COMMITTEE ON PUBLIC ACCOUNTS ON THE ALLEGED CORRUPTION IN THE PHILHEALTH WHEREAS, Article XI Section 1 of the 1987 Constitution states that “Public office is a public trust, Public officers and employees must at all times be accountable to the people, serve them with utmost responsibility, integrity, loyalty, and efficiency, act with patriotism and justice, and lead modest lives.” WHEREAS, on 23 July 2020, various news sources reported an Executive Meeting of the Philhealth where corruption issues were raised. The discussions became heated which lead to the resignations of several personalities; WHEREAS, the resignation letter of one of the attendees was circulated in social media Atty. Thorrsson Montes Keith, anti-fraud legal officer of the said agency, stated that his salary has not been given on time since he started investigating PhilFlealth officers allegedly involved in corruption;? WHEREAS, the resignation letter also stated in essence that Overseas Filipino Workers should not be burdened with paying for the “spillages” of the agency;? WHEREAS, it should be noted that the Philhealth has had its share of issues of corruption in the past; WHEREAS, in June of this year, Presidential Spokesperson Harry Roque tweeted the agency for supposed inaction after reports of missing P154-billion funds within the agency through "fraudulent schemes" went viral’; + https://newsinfo.inquirer.net/1311174/source-says-deep-corruption-in-philhealth-forced-3-fed-up-execs-to-quit 2 https://news.abs-cbn.com/news/07/23/20/philhealth-officer-resigns-due-to-widespread-corruption-in-agency 2 htps://ennphilippines.com/news/2020/6/22/Ricardo-Morales-denies-PhilHealth-corruption- allegations htm|?fbclid=lwARINI8_ 3038aPViloCvsr_LUv-IWo6NEDcwdlQCmBICiOEXfstz1947H FAWHEREAS, in August of 2019, it was reported that “Commission on Audit (COA) has called out Philippine Health Insurance Corp. (PhilHealth) for the surge in the number of cases and claims of members, particularly those in Metro Manila and Rizal province, for pncumonia, acute gastroenteritis, urinary tract infection, sepsis and other diseases”. WHEREAS, news sources stated that “the prevailing all-case rates (ACR) payment mechanism was one of the ways the health insurance company had lost a total of P154 billion since 2013. Of the “losses” over the past six years, P102.5 billion was due to overpayment”®, WHEREAS, a Senate Senate Blue Ribbon Committee in 2015 investigated a surge in benefit reimbursements where senior citizens were supposedly forced to undergo cataract removal. “For every cataract surgery, an outpatient procedure that could take as quickly as 15 minutes, PhilHealth reimbursed P16,000. In 2014 alone, PhilHealth reportedly paid P2 billion for such claims, equivalent to 125,000 procedures”®; WHEREAS, when there seems to be a pattern of alleged abuses where loopholes can be taken advantage of by the unscrupulous, a systemic change needs to be done to overhaul the present setup; THEREFORE, be it resolved as it is hereby resolved that the Committee on Public ‘Accounts of the House of Representatives conduct an inquiry in aid of legislation on the alleged corruption in the Philhealth. Adopted, MICHAE//T, DEFENSOR * https://newsinfo.inguirer.net/1150035/coa-questions-surge-of-philhealth-claims-in-ncr-izal 5 hntps://newsinfo. inquirer. net/1127693/philhealth-lost:p154b-to-overpayments-fraud © ttps://wwwphilstar.com /business/2019/06/20/1927841 /corruption-and-inefficiency-philhealth