Senate Hearing Aug 4, 2020 – PhilHealth Hearing

Time stamp: (6:20:47)

(started with Senator Villar commenting that they have many employees who are Philhealth
members and that all of them underwent PCR tests)
Sen. Villar: (last question) Interim reimbursement mechanism. Philhealth gave 15B to 700+ hospitals.
Kung iddivide yung 15B sa 700, that’s 20M per hospital. Asked for the list of hospitals:
Government and Private. Kasi yung government alam niyong hindi magpapalakas sa inyo dahil
government, kaya private lang iniintindi. (Unnecessary comment in my opinion) Purpose: To know
whether there was an equal disbursement to private and government hospitals.

Sen Sotto: Asked if Pargas needed a subpoena duces tecum for the list or willing to submit? (You
don’t ask the custodian if they want a subpoena. Not the proper procedure in issuing subpoenas. It’s
the court’s discretion if they’re going to give the same.)

Sen Bong Go (HAHAHHAHAHA TANGINA MO!): “I challenge the President of Philhealth to weed
out the corruption in their agency. xxx Not even a single peso should be lost to corruption in this
time of crisis. ‘Every peso counts’ sabi ninyo nga sa Joint Congressional Committee. Your premium
collections dropped in the first half of 2020, the Government is already doing its best to find sources
of funding to keep Philhealth afloat to continue the implementation of Philhealth. (Isn’t Philhealth
part of the GAA? Why is the government looking for new sources of funding?) Kaya hindi talaga
katanggap-tanggap na may nagbubulsa ng pera para sa pansariling interest. I urge the Ombudsman to
investigate kung sino dapat ang managot. Please get to the bottom of this mess. If there’s a mafia.
BG: Morales, you were appointed to stop corruption (did BG admitted that there was corruption in
Philhealth in the first place?)
Morales: Opo, Senator (Affirmed by Morales naman)
BG: Kaya pa ba? Kaya mo pa bang pigilan?
Morales: Kung itutuloy ang programa natin sa IT. Yun po ang malaking makakasagot sa issues natin
sa corruption. If may malaking budget sa IT, marereduce natin ang fraud.

Sotto: How does IT solve corruption?

Morales: Membership database. If we have an information system, may biometrics po tayo.
Malalaman natin kung buhay yung members. (At this point, there was an implied confirmation that
corruption is implemented by using dead/ghost members to fit their narrative of expenses). We
have 5,000 members in our database that are 130 years old, at hindi naming sila pwedeng tanggalin
sa database dahil we cannot confirm if namatay na itong mga ito. Maraming proseso ang manual.
Sotto: Eh procurement niyo yung may problema eh.
Morales: Kung malaki po ang budget natin, pati po procurement ioutsource natin yan. Ang kunin
po natin Google at Microsoft.
Sotto: Hindi yung pagbili ang problema nga eh. (annoyed)

Sen. Lacson: Mr. President, with the permission of Senator Go. Show us that your procurement is
maayos. (asked about the overpricing of Philhealth)

Morales: (tried to explain that it was because of failure to bid. Senator Lacson interrupted.

Lacson: That’s beside the point. Failure to bid doesn’t justify the overpricing. Anyway, Mr.
President, I received here a not that BM Cabading will show the overpricing from 2018-2019.

Sotto: We can do that after Sen Bong Go.

BG: Sir, pakisagot po yung tanong ko. Kaya bang sugpuin to?
Morales: (insisted on their IT System)
BG: to BM Cabading. BMs ay pinalitan ni Presidente nung nakaraang taon at kayo po ang itinalaga
diyan, para linisin ang Philhealth pero wala pa ring nangyari. (unnecessary comments. Delaying
proceeding) Ano pang maitutulong mo? Para sugpuin ito? As a Board Member? And as [an]
accountant.
Cabading: Tinawagan ko si Harry Roque. Roque said, “Eh di sulatan mo yung Presidente and
address it to me. And that letter was also addressed to you [Bong Go]. Now, yung question na yon, I
hope you don’t mind, I’m sending it back to you. We’re sending it back to you through this
investigation. It’s now in your hands.” (rarely you hear this answer from a presenter/participant)
BG: Ang ibig mong sabihin wala sa BMs ang problema? Nasa baba? Mga plantilyadong
Cabading: Top Executive! I believe these are members of Executive Committee! Number 1 diyan si
Limsiyaco (?). people who are manipulating eh
BG: Sino pa?
C: Del Rosario. And the corporate secretary.
BG: Kung ikaw ang Presidente ng Philhealth, anong gagawin mo?
C: I’m not going to answer.
BG: Kung sakali nga.
Sotto: Question is theoretical.
(trying to extract an answer from Cabading which is not even necessary to the investigation. Bong
Go’s time to question is wasted by asking questions not related to the fraud)
Cabading: there are many avenues to address this corruption, you only need to identify the people.
(at this point, Cabading’s answers are becoming informal as his annoyance is starting to manifest.
However, I commend his attempt to keep the investigation stay on the status quo since it’s obvious
that BG’s questions are out of line).

Sotto: Atty Cabading, listen, I’ll cut you. You’re blasting here and don’t shout. We understand how
you’re feeling. Address the chair when you want to say something. You’ve already said the names.
Ituloy tuloy mo na.
Cabading: I already mentioned Chairman Del Rosario, Renet Limsiaco, Ben Ismas (?), Atty
Mangawang (Corporate Secretary)
BG: Sa tingin mo may gamot pa itong problema sa Philhealth (OMG BONG GO SERIOUSLY?
THAT’S YOUR QUESTION?)
Cabading: *heaved a sigh of frustration* Palitan po ang mga taong namention ko.

Sotto: Were they there during the time of CEO Ferrer?

C: Yes, Mr. Chair.
S: Ferrer was asked to resign and was now in DOH? Saan na siya?
C: No idea.
S: Do you know where Ferrer is now?
Morales: I think he’s under DOH, Mr. Chair.
S: Undersecretary? Okay, Senator Go, go ahead.

BG: Nakailang president na tayo ng philhealth. Pero wala pa ring katapusan ang corruption. Wala
pa ring nakukulong. I’m urging the ombudsman po. Dalawang taon na lang po ang natitira ni
Pangulong Duterte, dapat wala nang masayang po. Mr. Morales, totoo po ba hanggang ngayong
taon na lang po ang pondo ng UHC? Sa susunod na taon, mahihirapan na po kayong iimplement?
Morales: Mauubos na po ang 130B at the middle of next year.
BG: Last question, Mr. Jimenez. Ilang beses na po akong nag-referee sa inyong dalawa ni President
Morales. Muntik pa po kayong magsuntukan. Kamusta po ang unpaid claims ng Philhealth last
year?
J: Regular meeting. Sasabihin noted pero walang regular payments. Naglockdown na po yung Iloilo
hospital pero wala pa ring IRM. Iba po yung policy sa area at sa hospital. Kaya hindi nagtutugma.
Marami pa pong utang ang Philhealth pero hindi tinatanggap.
BG: Nabanggit po ng ating mahal na pangulo, gusto po niyang malaman, makasuhan ang dapat
makasuhan. Meron po bang another set ng masisibak? Sino bang nasa baba?

Bato Dela Rosa: I would like to ask this question to the senior VP for legal - Atty Del Rosario. This is
about the background of Perpetual Succor Hospital case. The accreditation of Philhealth meted the
sanction of 3 months suspension of said hospital due to cases of overstaying or patients were made
to stay in the hospital despite doctor’s go-home order. This case was appealed to CA which upheld
the sanction on 2018. Philhealth board during Dr Ferrer purportedly implemented a new set of rules
and regulations for the Philhealth Act, decided to do away with the penalty of revocation or
suspension of accreditation, and lowered to mere fines. On Jan 10, 2019, removed the suspension of
the hospital and increased the fine with restitution of benefits unnecessarily paid by Philhealth.

Del Rosario: Before answering your question, Your Honor, I would like first to deny that I am a
member of any mafia or syndicate. We have been fighting against corruption. When I was asked to
step aside, I took a LOA of 5 months during the investigation. If Mr. Cabading cannot substantiate
these allegations [against him] we will take the necessary actions. Yun pong information technology
ang naglabas ng fraud sa mga hospitals at kung anu-anong areas. At noong inassign na ang regional
heads doon po nagkagulo. We have 4.9B worth of fraud but these regional heads are acting as
spoiled brats, refusing to be reassigned. Senator, the alleged whistleblower was removed during
your time as PNP Chief – Atty. Toson Kit (?). And his appeal in the CSC and CA ay ibinasura. Hindi
ba? Kayo ang nagpatanggal? (Atty Del Rosario is shaking his head in frustration. Improper court
decorum)

To answer your question, it was a decision rendered by the Philhealth BOD based on a policy even
before I was assigned in this position. The Board Resolution to convert decisions affirmed by higher
courts considering that our people need access to our services. The UHC law states that the penalty
of revocation is removed, at nilagay po ninyo [the legislature] na ang suspension ay three years lang
dahil ito ay in recognition ay dahil hindi natin pwedeng iparalyze ang [Philhealth] services.

Dela Rosa: Kaya siguro namimihasa ang ibang Philhealth claimants. Dahil decided na nga ng CA na
dapat parusa, and yet, you refused to implement the decisions. For what reason? You’re depriving
Philhealth of millions of pesos by doing that decision.

Del Rosario: It appears that if you extend confinement, mas maraming babayaran ang Philhealth.
That’s why the rationale of the board ay hindi na commensurate sa crime yung magiging parusa.
The board resolution is based on equity –

Dela Rosa: I will cut you short there. Sino bang miyembro ng board dito na pwedeng sumagot?

DelRo: Wala sir eh. Dahil nagresign na po.

Lacson: With the permission of Senator Dela Rosa… (no answer from Bato but Lacson continued)
Who travelled to London after the commutation of the CA decision? By the way, it was final and
executory. It’s good that they discuss judicial procedures in this case. And then the fine imposed by
the board naging 10,000 na lang. Ilang milyon ang nawala sa gobyerno doon. Biglang andoon lang
kayo sa Heathrow airport. Papicture-picture pa (not relevant to the case). I think that’s Mangawang,
Pargas etc.

Atty. Mangawang: I’m not involved in the Perpetual Succor.

Lacson: *referring to the pictures of Philhealth executives in London* Kitang kita pa kayo dito.

- Dead air –
Bato: Basta ang importante lang dito maestablish natin na ang board resolution ay hindi under
influence or duress para pagbigyan ang violators.

Atty. Mangawang: Sir, if I may answer… This board resolution was extensively discussed in the
Senate Committee on Health and Demography (to which Bong Go is the Chairman) and the Senate
Blue Ribbon Committee on September 25, 2019. The justifications were also heard. You are correct
that this Perpetual case was elevated to the CA but this petition for review was dismissed October
2017 and a MR but also was not granted in March 2018. When Perpetual Succor received the writ for
execution from the Arbitration office sometime in November 2018, the hospital filed an appeal
before the [Philhealth] board and this matter was heard before the CAAC which is the appropriate
board to hear this kind of administrative cases. And that CAAC recommended for Perpetual Succor,
praying that their appeal be granted on the ground, among others, that Perpetual Succor is the only
private hospital in the entire region 7 that provides the “C-benefit packages” which covers
catastrophic illnesses for breast cancer, leukemia etc. plus there were letters from Philhealth
members. With the guidance from the legal department, there were exceptions to the doctrine of
immutability of court judgment (take note of this because important. Define what immutability of
court judgment is and whether it applies to legislative hearings). The board decision was approved
and signed by all 15 board members present during that meeting wh-

Bato: okay nakuha ko na yung sinasabi mo. Ang sa akin lang bakit tayo insisting (sic) pagbigyan
itong violator na… ang decision naman ng CA ay favorable to Philhealth. Bakit parang pinapaboran
pa itong violators? Yung iba diyan sige na lang magviolate dahil nakikita nila wala naming
implementation ng korte. (Bato has a point. But we should consider that this was an exceptional
circumstance. Even the legislative committee agreed since it was extensively discussed that the
doing away with the court judgment was justified. Hence, it was a mistake on the part of the
legislature when they also approved the move of Philhealth. What the senators should do now is to
review their prior decisions, or strict their discretions as to prevent this kind of mistakes. They have
an error in this too).

Lacson: If I may interrupt, Senator Dela Rosa? (Yes, Senator). This is part of the letter that I received
from Perpetual Succor, ‘PSH accepted its fate from being barred from admitting PHIC members.
Besides, PHIC has not paid claims (in millions). ‘ and ‘word reached PSH that an appeal may be
filed with the new PHIC board.’

Dela Rosa: Tingnan mo…

Lacson: Sino nagsabi—we’re not born yesterday! So don’t fool us. Sino nagsabi ng “Magappeal kayo
sa board, pagbibigyan naming kayo.”
Bato: *almost shouting* Kayo pa pala nagencourage sa kanila na magappeal. Very detrimental on
the part of the government. Bakit ganon? Kaya naubos ang pera ng Philhealth dahil sa
katarantaduhan na andiyan. (unnecessary comment)
Mangawang: This Perpetual decision was not the first time the Philhealth board modified the
decision of the CA. Prior to this, 11 of 12 cases decided by CA and affirmed by the SC, and these
decisions were reversed by the board.

Bato: Ay… Sige.

Pia Cayetano: Mr. President, with the permission of Senator Bato (Yes). Can we direct the corporate
secretary to produce the minutes of these board meetings. At least we can see what has been
recorded. So it’s a request for the documents.

Sotto: Can you specify which dates so we can issue a subpoena duces tecum (again, inconsistency in
the rules. Sotto decided that they will issue subpoenas but before he’s asking if they want a
subpoena. Make up your mind sir). Mas mabuti yon kesa sa irequest mo (oh diba)

Pia: My request is general. Any minutes that covers this subject matter.

Sotto: We’ll have the secretary look into it. Senator Bato, you still have the floor but Sec. Mas wants
to be recognized. (pwede ba to)

Bato: tapusin ko lang to. Going back to Atty. Del Rosario. Ito ha hindi ako namemersonal sayo.
Gusto ko lang maklaro. Ano bang qualification ng SBP for legal? So lahat ng ito qualified ka?

DR: Yes, Your Honor. Contrary to the chismis na kinakalat ng mga tunay na sindikato. My
appointment is CSC validated. The 5-year law practice is not necessary dahil generic po yung
position. Nagkataon lang po na ako po yung abogado kaya ako po yung nasa legal.

Bato: Is it true that you’re engaged in taxi business in Baguio?

DR: Yes, your honor. But I only own three.

Bato: May time pa ba ako? (informal) General Morales, kilala kita sa AFP bilang isang napakatino na
opisyal. Kilala ka na opisyal who did not compromise his principles for any favors or comfort. At
kilala rin kita as a vocal critic ng corruption at ng katarantaduhan ng gobyerno. You were even
hitting the Duterte administration. I can still recall inutusan ako ni then-mayor Duterte na puntahan
ka sa Bukidnon at iparating ang mensahe ni Mayor. At ako rin, being your junior, are looking up to
you as standard bearer of courage and integrity. You were perceived by President Duterte as the last
option to end the Philhealth corruption. Kaya kahit critic ka nya, kinuha ka nya. (is this really
necessary?) Para tapusin itong problema na to. After one year, at still itong problema ay persisting.
Can you honestly answer this question, did or did you not fail the President? (this is not a private
concern, sir. This is a matter imbued with public interest. The whole Philippines is failed)

Morales: My answer is that I have finished my job. What was supposed to be done is not yet done.
And I’m not finished until the information system is up and going. Para po akong sirang plaka dito
pero kahit saan ko ho tingnan, background ko, experience, reputation ko sa labas, hindi po sapat
para maayos ang Philhealth. Hindi enough yung intentions, loyalty etc. At sa tingin ko ang tama ay
paandarin at ayusin yung information system at linisin ang database. Inaamin ko ho na kulang ako
sa paghanap ng katiwalian.

Bato: Thank you for honestly answering that question. If I recall marami kang inexpose na anomalya
diyan. I know you’re instrumental noong may nangyari doon sa Amerika. You are shrouded with
doubts dahil lahat ng ito nangyayari under your supervision. I hope and pray that you bail yourself
out of this predicament para naman hindi kami madiscourage, kaming mga juniors mo looking up
to you. (OMG really??? BIASED AMPOTA)

Mr. Dennis Mas: Si BM Cabading namention na yung name ko dahil ako daw in charge sa mga tao
sa Philhealth. Senior VP po ako ng Management Service Sector. Isa sa mga issues ngayon ay yung 4
promotions na allegedly involved in the Wellmed ? case. Rule 4, par. 3 of CSC rules - the pendency
of administrative case shall not be a bar to a promotion. If you’re still serving your service, bawal.
Ang status ng case ay complaint pa lang. Lahat po ng appointment naming ay CSC validated.
(explained the procedure of appointment. The demeanor did not change. The Senate committee did
not comment).

Sotto: Okay, thank you. That’s enough.

Sonny Angara: I’d like to note that sa mafia na sinabi ni Mr. Cabading, isa lang ang nagdeny na
myembro siya. (laughs) Mr. President, I’d like to ask Mr. Morales if hindi po naadmit yung pasyente
pero walang mga kwarto at namatay siya sa ER, is he entitled to a reimbursement from Philhealth?

Morales: Yes, Sir. Ano ho ang sakit niya?

Angara: *Laughing* may nagpapatanong sa akin from the media. Because he was denied Philhealth
reimbursement because he died from Covid in the ER.

Morales: Depende po sa diagnosis ng physician.

Angara: Anyway, your answer is on record naman. Kayo po ba nagrecruit sa mga whistleblowers
natin?

Morales: Hindi ho. Ang kinuha ko lang po si Laborte. Siya ho ang nagrecruit kay Torson. Si
Cabading was appointed by the President.

Angara: Ano ho ang nararamdaman niyo ngayon that you came in with hope to institute reforms.
Bakit parang hindi niyo sila [whistleblowers] kinakampihan?

Morales: Specifically to Atty. Torson, he was vengeful because I don’t want to give him a position
[Morales is cleaning his desk while answering. I noted it here because I found it weird.] Ang totoo niyan, he
came to me dahil maliit ang sweldo niya. Hindi ko naman siya ganon kakilala. I recently learned
that he was kicked out from the PNP in 2013 for being AWOL and that in 2010, as a graduating PMA
cadet, he resigned from service. Right now that he’s not with Philhealth, he has 4 sexual harassment
complaints, that’s why he’s not qualified for head executive assistant.

Angara: Assume na natin na may galit po siya sa inyo, wala po bang totoo sa sinabi niya? Na may
pinapaboran po kayong hospital? At may 15B worth of overpricing and fraud, at kayo po mismo
nagsabing may fraud hindi po ba?

Morales: Meron po. But I categorically deny his allegations against me. In his 9 months that he has
been in the corporation, wala po siyang sinumbit na fraud report. At ngayong nasa labas siya, may
sinasabi siyang fraud at may figure pa siyang 15B, gusto ko lang malaman kung saan niya nakuha
itong figure na to.

Angara: itanong ho natin sakanya. Atty. Torson Keith, saan po niya nakuha yung 15B?
Atty Keith: yung sinasabi ko pong 15B sir ay dahil sa IRM. Sa IRM hindi po pwede yung cash
advance dahil kailangan ng claims. Sa IRM ang sinabi ko doon humigit-kumulang 15B. So meron po
yung IT doon eh. Ang sinabi ko po doon ay winaldas po nila in order to cover up. Bakit mo
irerelease yung cash advance na wala kang authority and basis?

Angara: Sa tingin niyo ba nagkakalagayan diyan sa mga hospital? Like Chinese General Hospital na
hindi pa bayad. Pero yung ibang hospital nakakuha ng worth 43M of reimbursement for
pneumonia.

Keith: Sir yung very specific sa baba, wala na po akong ebidensya doon. Pero sa pagrelease ng pera
wala po silang authority doon. Next is yung pag-defer ng liquidation at wala po siyang withholding
tax. Hindi na nga nakakuha ng tax yung government may violation na po.

Angara: Thank you. Can I ask SVP Del Rosario, is he the longest member as stated by Mr. Cabading?

Del Rosario: Yes, your honor.

Angara: [asked for Del Rosario’s background: where he took up law, whether he is a working student] Is it
true that you made a change when you became the head of legal – centralized lahat ng arbitration
and settlement of claims sa inyo po. Meaning hindi na po dadaan sa BOD?

Del Rosario: Not correct, Your Honor. The reimbursement processing is with the regional offices.

Angara: Hindi ho, kapag tapos na sa regional offices. Hindi ba inaakyat na sa inyo ‘yon?

Del Rosario: Administrative protests are handled by the protests and reviews department, th—

Angara: That’s the PARD? (Yes) But isn’t PARD under you? So ang decision ng PARD sa inyo rin
mapupunta, tama ba?

DR: No, your honor. My role in the protests is administrative supervision. The authority granted to
approve or deny the administrative protest is lodged with the head of PARD.

Angara: I got the information that when the arbitration and settlement claims went to you, you
immediately reversed in a short span of time almost 4B worth of claims which were paid
immediately by Philhealth. What can you say?

DR: That is inaccurate, Sir Senator. None of the resolutions pertaining to the payment of protests
goes through my office.

Yung imbestigasyon namin last year, one of the points raised in the Blue Ribbon Committee, there
are 5,622 arbitration cases sa inyong department but only 1,000 were resolved. Meron bang progreso
since then on the remaining cases?

Linawin ko lang na ang arbitration cases are not administrative protests. Ang arbitration ay separate
office not under the legal sector, but under another VP

Sagutin na lang po natin yung tanong. (how can he answer if it’s not within his department)

Tinext ko na po yung VP. Bumilis po yung processing under General Morales dahil nagkaroon tayo
ng backlog strategies. The resolutions of cases were faster.
Sir, you’re answering cases I haven’t asked. What I’m asking is regarding the almost 4,000 cases that
were flanked during the blue ribbon committee. Do you have a number?

200 na lang po ang may kaso. If I will convert this, nasa almost 3k cases so—

Disposed of in a year’s time?

Opo.

Eh kaya naman pala na mabilisang disposition. I’ll go back to Morales. Have you ever talked to
hospital administrations? Sabi niyo there was fraud of 10B in 2019?

Estimate lang po yan

Have you identified the weak spots in the Philhealth?

We have 20,000 cases, 10,000 are in the region. These are potential reasons. We need a forensic audit
because it doesn’t appear in the books.

Why don’t you set that in motion? Hearing what Mr Cabading said, the mafia is composed of
veteran officials of Philhealth kaya madodoktor nila. Sabi nga ng COA kulang kulang lagi ang audit
reports. Hindi po ba dapat matagal nang ginawa yang forensic audit?

Last year puro guess work lang po ang aming estimate. 2016 estimate po ay 10% sa lost to fraud. Ito
po ay academic and scholarly study headed by one Dr. Lam who came up with this figure. This is
the only time na hindi guess.

Did the study pinpoint the weak spots for the fraud?

Marami po yon. Healthcare is prone to fraud even in other societies dahil hindi po natin
matatanggal yung face to face transaction ng patient and physician. Kapag nagkasundo po sila eh
lagot po yung healthcare insurance diyan. Kahit po sa mga advanced na bansa. Yung sa atin po na
7.5% is still lower sa estimated 20% sa developing and 8% sa developed countries. Kaya ho I’m still
skeptical of the 7.5%. We’re still investigating on the 20,000 cases. Baka ho mas makakasagot si SVP
Del Rosario dahil siya ho ang nakatutok sa fraud investigation.

I’ll just ask him that later. Anong pakiramdam niyo? Hindi ba dapat may action kayo about doon sa
mafia? Or hindi kayo naniniwala sa sinabi ni Mr. Cabading?

I don’t believe because he also has a motive. He wants us to buy this property in Zamboanga and he
has acts against management. Mahirap ho magsabi na people are involved in a mafia unless there is
evidence. I’ll be very careful in using this term dahil kung hindi tama dahil wala naman pong
ebidensya.

Sinabi po na yung IT purchases seem to be overpriced, but you’re still defending it. Have you
changed your position or yun pa rin?

I think we are undercosting on what we should invest in information system. Ang dapat po diyan
5% ng expenses IT expenditure. Last year we spend 136B, we should spend 7B on IT. Eh ang
nangyari we’re only spending 2.1B in 3 years. Kulang pa ng tao sa IT. We are not spending on the
single time that would help the Philhealth, in a major way, sa fraud.

Sotto: Was that your question?

Hindi po *laughing*. Ang tanong ko is his defense in the IT report presented by Miss Aragona that
is overpriced.

Yung term po na “overpriced” ay hindi galing sa internal audit report. Ang galing sa IAR ay
“discrepancy.” At ang ginamit po yata na word ay, I think, “inconsistencies.” There should be a
rectification of which price is the right one for this item.
(Author’s note: As an auditor, we don’t really use the term “overpriced” because that’s not included
in the GAAP. We use “discrepancy” even in describing substantial differences in numbers.
“Inconsistencies” is no better dahil given siya ng greater weight when it comes to audit findings.)

So what is the right price? 6,000 or 320,000?

Ilalabas po yan sa rectification process. Baka sa number of units.

Sotto: That’s per unit eh. Halata naman. You’re raising your hand. What’s your name? Have you
taken your oath? No? Okay, please rise. [Gabuya took an oath]

Gabuya: I just want to clarify yung overprice na allegedly 60,000 na switch. Yung 74M na contract—

Angara: Who is he and what is his qualification in this testification?

Gabuya: Acting Senior Manager po ng IT Service Management of Philhealth under the Information
Management

Angara: Hindi naman kita tinatanong ba’t sumasagot ka? (this is inappropriate. You recognized him
and was put under oath. You wasted time here).

Morales: The reason why I asked Mr. Gabuya to answer is because he knows better the details of the
question at hand.

Angara: *slightly annoyed as manifested from his change of voice* I’m not asking about the details.
I’m asking if there was an overprice and it was clear that, for you, there was.

Morales: No, Senator. There was no overprice.

Angara: Do you know any case of hospitals having duplicate box to have their claims processed?
Nagbabayad ang hospital para mauna silang mabayaran.

Morales: I’m not aware of that process and how it carries out.

Angara: Are you not investigating this? Is this your first time hearing this?

Morales: uhh, yes sir. I cannot confirm that that ever happened.

Angara: Eh ang dami naming naririnig na ganyan. Siyempre hindi magsasalita ang mga hospital.
Marami nang kwento kwento. Sapagkat kung nagbayad sila, sangkot sila. Pero yung mga usap usap
between administrators, may sinasabi ba silang nagbayad sila? (first of all, you cannot raise
questions without any substantial evidence. If you’re going to question on hearsay, offer it formally
and let the Chairman approve the same).

Are you willing to give the names of these facilitators, hindi naman naming isasapubliko, but for
internal investigation purpose, Dr. Jimenez?

Jimenez: Hindi ko na po matandaan eh.

Angara: I understand, Sir, dahil pinoprotektahan niyo rin po yung mga hospital. (Insinuating that
Jimenez is part of the facilitators) Back to Mr. Morales, tingnan niyo na lang ho baka may mga suki
diyan. Kasi yung WellMed parang dalawang araw pa lang nabayaran na. So look into it. I just want
to request for a special audit investigation, and this is provided for in the UHC law as authored by
Senator Drilon. It’s about time to look into the depth. And invite COA in the next hearing para
magtagisan sila ng findings and claims. I do agree with President Morales that we need to invest in
IT, but this should not be an investment in black hole, meaning, hindi natin alam saan napupunta
yung pera kailangan may hangganan and finish line. I would also like to suggest appointments of
Independent members of the Board. (I commend Angara’s suggestion to invite some executive
bodies who may have an inkling in the case at bar)

Pia Cayetano: I chaired the Committee on Health in 2004 and in 2010. And there’s a survey which
showed that almost all of the hospitals reimbursed by Philhealth are private hospitals, meaning,
poor patients cannot avail Philhealth. In pursuant to the Bayanihan: Heal As One Act, we sent
weekly comments on the reports submitted. There was a 13.2B to 562 Philhealth accredited
healthcare institutions, how are these disbursed? President Morales?

Morales: This amount is based on the historical claims of the hospitals. We submitted weekly reports
in the Office of the Executive Secretary. I have now the breakdown of the IRM which is about 14.9B
to 771 hospitals are released.

Cayetano: Since we received that, we reserve the right to ask questions about that in the second
round. Since we’re talking about the internal reimbursement mechanism (IRM), and this is about the
release of Philhealth funds during fortuitous events. How come yung mga hospitals, who at that
time were not dealing with covid, eh nakareceive ng pagkalaki-laking amounts? At ang sagot ninyo
dahil precautionary, baka mangailangan sila. But the circular specifically says that it is for fortuitous
events. How can you justify that? And please don’t tell me na nangangailangan sila because of these
other ailments (cancer, dialysis etc). So meron ho kayong pagkakamali dito because this mechanism
is for FE?

Morales: Yung mga nabigyan po ng IRM na hindi covid-related allocated in high covid areas like
NCR. Affected din po sila ng covid.

Cayetano: Meron pong lumalabas na information na malayo po sa NCR at walang report nabigyan
ho eh. That was already established earlier. My question is, what are you going to do about those
hospitals na nabigyan?

Morales: Illi-liquidate po nila yung IRM nila.

Cayetano: Pero Sir, on your part, it was erroneous to release those funds.

Morales: We did not know there was no covid in those areas.

Cayetano: Sir, parang wala pong logic eh.

Morales: Gusto po nating unahan yung spead ng Covid. For example, Bicol, kahit wala pa silang
covid meron na sila. Pero sigurado ho yung mga referral hospitals meron na ho preposition na IRM
fund. I think it’s still too early to say na hindi kakailanganin.

Cayetano: But I was reacting to your answer earlier na “meron din naman silang pangangailangan na
non-covid.”

Morales: it’s not a perfect system. Kaya siguro may mga nakakatanggap at hindi nakatanggap.

Cayetano: *frustrated na* But doesn’t that require an investigation? It is not a matter of the system
being inefficient.

(paikot ikot na lang sila dahil inuulit lang ni Morales yung sagot niya)

Gordon: I seem to have summed up the problem of Philhealth: Palit kasi kayo ng palit ng presidente.
Sa tingin niyo Mr. Morales, do you think this is a good idea?

Morales: I think it’s not wise to change because there’s a stability required in running a big
corporation.

Gordon: so walang continuity? At napapapabayaan? Tama po ba yon? Kaya nagkakaroon ng

sabwatan sa hospitals?

Morales: You are correct, Sir.

Gordon: During elections, kukunin yung budget ng Philhealth at ipupunta sa mga projects na hindi
naman Philhealth related. Tama ba yon?

Morales: hindi ho dapat. Dapat sa healthcare services lang po.

Gordon: So doon pa lang mali na? Dahil kinuha pa para pampakintab sa national elections at that
time? At nakita naman ng COA na meron talaga mga overpayments every year. At hindi pa
nabubuo yon dahil walang access.

Morales: Meron po kaming resident COA auditor na meron po silang access sa files po naming.

Gordon: Well that’s not what he said. Kaya nga he insists on going with the COA investigation.
Hindi sila nakakakuha ng information. Kaya gusto niyo magkaroon ng IT? Tama po ba yon?

Morales: Opo.

Gordon: At para mapabilis ang paghahanap? Katulad ng 2.1B na gagastusin natin [for the IT]? Tama
po ba yon? At ano po ba yung tamang amount originally? 1.1B? At nakakuha kayo initially ng 20M?
At nakakuha kayo ng additional na 328M?

Morales: Sir, if I may, si SVP Aragona po ang sumagot dahil siya ang Chief of Corporate Information
Office.
Gordon: Sige.

Aragona: 25M is for the virus sweep. The supplemental budget of 379M supposedly for
procurement. Kasama po sa 379M yung ibang items needed for database and redundancy.

Gordon: It’s a good idea pero nagkagulo gulo na ang Board. Halos nagkakasigawan na nga kayo.
Pati mga inappoint ni President nagagalit na. Ewan ko kung totoo yon pero yon ang nababalitaan ko
(we cannot assume since this is an investigation). Personally, we need IT. But with the overpricing
and the overpayments we will leave this at it is and continue with the investigation. Example for the
overpayments to private hospitals, Oligario General Hospital – actual charges: 5M; total Philhealth
reimbursement: 38.2M; Eastern Sun Medical and Diagnostic – actual charges: 4.7M; reimbursement:
29.6M. Kaya maraming overpayments. Kaya nagkakagulo yung iba gusto ng case rate, yung iba fee-
for-service eh nalalaro yon. I’m sure you know na nalalaro yon kaya nagmamahal.
- Senator Gordon got disconnected. The senators are laughing because of their ICT problems –

Mr. Mas: Sir, can I add something? Regarding COA audit?

Sotto: Sure, Mr. Amas. While waiting for Senator Gordon.

Mr. Amas: The COA audit was divided into teams and one team audited the all-case rate, one team
on collections and remittance of Philhealth payments. These audit investigations were requests by
the Blue Ribbon Committee last year. Kaya yan po yung pinaka-update. Also, last year, the
Insurance Commission and Philhealth entered into a MOA para ireview yung processes ng
philhealth and to come up with recommendations.

Pacquiao: Thank you, Mr. President. Ang una ko pong katanungan –

Gordon: With all due respect to Senator Pacquiao… Of course we have to appropriate, but how are
you preparing during the lockdown?

Morales: We tried operating during the lockdown and we’re protecting our personnel.

Gordon: Kaya niyo bang magbayad or nahihirapan na kayo magbayad?

Morales: Kaya pa po.

Gordon: Eh bakit mabagal? Yan ang sinasabi sa amin

Morales: We already paid 380M for the testing. Are you referring to the Red Cross, Senator?

Gordon: No, I’m not just referring to the Red Cross. I think you still owe us 260M, and I’m sure
you’re aware of it pero hindi kami humingi ng pang-testing sa inyo. Ang sinasabi ko lang, kawawa
naman yung mga hospitals. Saan pupunta ang mga tao. Ilang testing ang binabayaran ninyo?

Morales: One of the purposes of the IRM ay para po may gagamitin po sila doon.

[Senator Gordon being asked to wrap up]

Sotto: Now, Senator Manny Pacquiao.

Pacquiao: Ang una ko pong katanungan, General, bago niyo po ba tinanggap ang pamunuan ng
Philhealth alam niyo naman po ang corruption allegations against that institution. Ano pong mga
ginawa ninyo?

Morales: Nireview ko po ang system ng philhealth. Hiniling ko ang mga executive na mag-leave
para magconduct ng investigation. Nilipat ko po ang ibang VPs ng posisyon at iniba ko po ang
proseso ng Philhealth para maging efficient. Sinubukan ko pong iimplement itong information
system.

Pacquiao: Alam niyo po na may corruption noong nilagay kayo diyan? (Opo) Bakit hindi niyo po
ibinulgar? Bakit kaming Senado pa ang magiimbestiga?

Morales: Yung corruption po dito matagal na po ito. Sa ngayon po may 20,000 fraudulent cases na
nakasalang. Itong imbestigasyon po na ito ay dahil lamang sa isang abogado na pumunta sa akin at
humihingi ng pwesto na hindi ko po binigay. Pero itong corruption po na ito hindi po namin
itinago.

Pacquaio: Sinabi niyo po na IT ang solusyon. Kalian niyo po naisip yan?

Morales: Pagupo ko po dahil sa laki ng transactions sa araw araw ng Philhealth. Internally, mga 4k
po ang gumagamit ng computer. Kaya malaking bagay po yung IT po at nang matanggal na ang
manual. At yan po ang ginagamit po ng mga bansang nakakaangat sa atin, fully integrated at
harmonized po ang kanilang system. Malinis at kumpleto po ang kanilang database.

Pacquiao: Maraming Salamat, General. Malaki po ang respeto ko sa mga uniformed – pasensya na
po sa diretsahan kong magtanong. Totoo po bang cuddler ng bagong leader ng bagong sindikato ng
philhealth. Totoo po ba ito?

Morales: Ginagawa ko lang po ang tingin kong tama pero tinatanggi ko po na ako ay cuddler.
Meron pong gumagawa ng katiwalian sa loob.

Pacquiao: Ano po ang plano niyo sa kanila?

Morales: Makabuo po ng ebidensya para po sa korte. Yun lang po ang naiisip kong paraan para
maalis itong mga taong ito. Kung may ebidensya ho ako, ako po mismo ang tatayo sa korte.

Pacquaio: [final words medyo nagdrama siya dahil nadudurog daw ang puso niya]

final words from the participants

End