Cases against PhilHealth:

1. Violation of Anti-Graft and Corrupt Practices Law

● Definition:
Section 1. Statement of policy. It is the policy of the Philippine Government, in line with
the principle that a public office is a public trust, to repress certain acts of public officers
and private persons alike which constitute graft or corrupt practices or which may lead
thereto.

● People Involved: Morales, De Jesus, Aragona, Limsiaco, Pargas,

Gabuya, and Crisostomo.
● Issue:
a. Irregularities in the implementation of the corporation’s interim
reimbursement mechanism
b. Overpricing of IT equipments
c. WellMed charges Philhealth for dialysis claims of patients who are
already dead

2. Violation of Article 171 of the Revised Penal Code (Falsification of

documents)
● Definition:
○ It is under the Republic Act 3815 or an act revising the penal code
and other penal laws
○ Falsification by Public Officer, Employee or Notary or Ecclesiastic
Minister. The penalty of prisión mayor and a fine not to exceed
5,000 pesos shall be imposed upon any public officer, employee, or
notary who, taking advantage of his official position, shall falsify a
document by committing any of the following acts:
●
○ Ex Pres. Ricardo Morales,
○ Senior VP. Jovita Aragona,
○ Senior VP. Renato Limsiaco Jr.
○ Senior VP. Israel Francis Pargas
○ Executive vice president and chief operating officer Arnel de Jesus
○ Officer-in-charge Calixto Gabuya Jr.
○ Division chief Bobby Crisostomo

● Issue: It was stated by an Ex-Philhealth official that this alleged syndicate

issues fake receipts to OFWs. Based on information gathered by the
 Committee, there is an estimated P1.2 billion worth of unremitted OFW
premiums.
○ It was noticed that there were two schemes happening, one of
which was retail fraud. Retail meaning, each OFW was given a fake
receipt. It was also noticed another wholesale level wherein the
hiring agency instructs its local officer no to remit to PhilHealth.

3. Violation of Republic Act No. 1051

● Definition: The law requires all government agencies, corporations and
local governments to deduct and withhold taxes from any payments they
make to private individuals or businesses

● People Involved:
Ex Pres. Ricardo Morales, Officer IC. Calixto Gabuya Jr.
Senior VP. Jovita Aragona, Senior VP. Renato Limsiaco Jr
Senior VP. Israel Francis Pargas Chief OO. Arnel De Jesus
Division Chief Bobby Chrisostomo

● Issue: The NBI complaint said the PhilHealth officials did not deduct or
withhold taxes from the IRM fund payments or cash advances to the
different private HCIs in violation of Republic Act No. 1051.

4. Grave Misconduct
● Definition: Grave misconduct is a grave offense punishable by dismissal
from the service.

● People Involved: Dennis Adre, Philhealth regional vice president in

Davao City,Roy Ferrer, acting president and chief executive officer of
PhilHealth

● Issue: According to PhilHealth’s preliminary investigation in March, Adre

was charged with repeated failure to comply to submit documentary
requirements needed by the Human Resource Department to renew the
contracts of casual employees of PhilHealth Regional Office XI warranting
a temporary removal from his post.

5. Dereliction of Duty
● Definition: *under ACT NO. 3815 – Crimes Committed by Public Officer
● People Involved:
 Dennis Mas (former Regional Vice President for PhilHealth NCR)
Ruben Basa (former Chief Operating Officer of PhilHealth)
Narisa Sugay (then-PhilHealth Vice President for Member Management
Group)
Gilda Diaz (Vice President, PhilHealth Office of the Actuary).
Rodolfo del Rosario Jr The Philippine Health Insurance Corporation
(PhilHealth)'s Senior Vice President (SVP) for the legal sector

● Issue:
-they failed to act on fake PhilHealth receipts issued for the premium
payments of overseas Filipino workers before the Office of the
Ombudsman.
-Sarmiento also accused PhilHealth officials of dereliction of duty and
grave misconduct and gross neglect of duty.

6. Gross Neglect of Duty

1. Definition: Gross neglect of duty is under G.R. No. 154083 refers to
negligence characterized by the want of even slight care or by acting or
omitting to act in a situation where there is a duty to act, not inadvertently
but willfully and intentionally, with a conscious indifference to the
consequences, insofar as other persons may be affected.
2. People Involved:
- Dr. Francisco Duque
- Ricardo Morales
- Renato limsiaco jr
- Arnel de jesus
- Israel vargas
3. Issue:
Gross Negligence in ascertaining the Interim Reimbursement Mechanism
beneficiaries without valid criteria for distribution.