Cabaero: Culpability

INVESTMENT scams. Get-rich-quick schemes. False medical claims.

All these have been in the limelight these past days because of warnings of regulators and the rising number of people and entities getting fooled. In the case of private sector initiatives, it is easy to determine culpability as government regulators can target owners and management. In the case of a government agency that outsourced services to a private entity, not only the private party should answer but also the government authority that is in charge.

The Securities and Exchange Commission (SEC), the agency that implements securities regulation, has been warning the public about illegal schemes. It named the Kapa-Community Ministry International Inc. (Kapa), Ada Farm Agri Ventures and Organico Agribusiness Ventures Corp. It said Kapa is allegedly involved in unauthorized financial investment schemes that promise 30-percent monthly returns, the Ada Farm is not registered with the commission and Organico does not have a secondary license to accept investments.

SEC said it didn’t want the public to fall prey to investment scams as it encouraged local government units down to the barangay level to reach out to the people to caution them against these schemes.

Here comes the anomaly over “ghost” dialysis sessions as reported by the Inquirer last week where the WellMed Dialysis Center continued to charge Philhealth, or the Philippine Health Insurance Corp., for nonexistent sessions for patients who had died or had not used up the free 90 sessions covered by PhilHealth.

It would appear that the one being fooled here is Philhealth as the WellMed reportedly charged it for the fraudulent claims. But, come to think of it, who funds Philhealth? Employees contribute monthly to Philhealth to ensure medical benefits in terms of discounts and free or subsidized treatment or procedures.

What worsens the situation is that the exposure of the anomalous practice came just as patients had called on Philhealth to cover more dialysis sessions. The Inquirer reported that patients were asking for more dialysis sessions to be covered by Philhealth.

Philhealth offers 90 free sessions a year with each patient getting the amount of P2,500 a session. Some patients said those required to have 120 sessions a year have to pay the remaining treatment from their own pockets.

For illegal practices to be stopped, government regulators have to show seriousness in getting to the persons behind these and those who are on top of the fraudulent scheme. In the case of the “ghost” dialysis sessions, there must have been an arrangement with someone at the higher echelons of Philhealth for the practice to continue through the years and result in millions of pesos of false claims.

Let the people responsible, regardless of how high up the ladder they are, account for this.

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