ROGELIO Pocallan Jr., senior manager of the Internal Legal Department of PhilHealth (Philippine Health Insurance Corp.), has been detained at the House of Representatives since he was cited for contempt of the House last Thursday, August 27.
The House committees -- (1) public accounts and (2) good government and public accountability -- ordered him jailed in the Batasang Pambansa for four days, or until Monday, August 31.
The PhilHealth lawyer angered lawmakers when Pocallan insisted that PhilHealth was allowed to reverse the ruling of the Court of Appeals in favor of Perpetual Succor Hospital (PSH) in Cebu City because it has quasi-judicial powers.
Pocallan. one of the PhilHealth officials summoned to the hearings, had admitted it was he who rendered the department legal opinion used by PhilHealth board of directors to overturn the CA ruling and lift the suspension of PSH for three months. The lawmakers said that only the Supreme Court could set aside the CA decision.
What infuriated Sagip Representative Rodante Marcoleta and Cavite Representative Elpidio Barzaga Jr. was Pocallan's insistence that the PhilHealth board had the right to do what it did for the Cebu hospital.
Barzaga told Pocallan that it was like the lawyer was telling the congressmen that they "should know that a decision of the Supreme Court, a decision of the Court of Appeals, even if it's final and executory, PhilHealth can change it."
PSH NOT ON TRIAL. Perpetual Succor is not being tried at the hearings in the Senate and the House over the PhilHealth scandal that has already led to the resignation of at least its two top officials.
What's happening is that the PSH case is being used as part of the evidence against officials who, the lawmakers believe, are not protecting the billions of pesos in public funds entrusted to the company.
Five years ago, in 2015, PSH was found by PhilHealth's prosecution department guilty of overextending the confinement period of two patients, ruling that the hospital be suspended for three months and made to pay a P10,000 fine. Perpetual Succor disputed the department ruling and sued PhilHealth before the CA, which upheld the legal department's order. Despite the appellate court ruling, PhilHealth's board later took out the penalty of suspension and instead slapped a much bigger fine, P100,000.
In effect, the alleged offense of PSH had been decided, all the way to an appellate court. What was being debated at the hearings was whether PhilHealth could change the CA-affirmed ruling and favor the hospital's interest.
NOT FIRST TIME. Perpetual Succor Hospital was also dragged to the national stage by two other major developments last year:
[1] Senator Panfilo Lacson, on August 18, 2019, mentioned the PSH case when he alleged that PhilHealth committed grave abuse of discretion when it set aside the order of its board of directors and Court of Appeals over "anomalous collections" by Perpetual Succor from the state health insurer.
Lacson recalled the Senate hearing in the previous week of that August, where officials pointed fingers at one another when a "mafia" at PhilHealth was mentioned. The name "PhilHealth mafia" that comes up at the current hearings is thus not new; as early as last year, before the pandemic it was already brought to the attention of national policy-makers.
The senator cited the testimony of William Chavez, then identified as regional vice president of PhilHealth-7. Chavez said he had recommended that PSH's accreditation be suspended for collecting P30 million monthly on allegedly fraudulent claims.
The arbitration department of PhilHealth issued on March 20, 2015 its decision suspending Perpetual Succor for three months and ordering a fine of P10,000. PSH sued before the Court of Appeals. But, even with the CA ruling that dumped the PSH lawsuit, the PhilHealth board raised the fine to P100,000 and removed the penalty of suspension.
An interesting footnote: Lacson also said the directors later went on a trip to Europe. He estimated that even with the travel expenses added to the P100,000 fine, the P90 million that would've been lost was a good bargain. (Lacson conceded he had no evidence that the PhilHealth people got the trip for free and the hospital picked up the tab.)
Lacson didn't mention something else that PSH may have also benefited from: the original PhilHealth board decision included an order requiring "the hospital to restitute any payment made by PhilHealth for claims subject to the case."
It was not just future income that Perpetual Succor saved from loss. It must also include past collections -- undeserved if indeed there was fraud -- which the hospital was able to keep and not return.
[2] Presidential Spokesman Harry Roque, on August 29, 2019 (at the time he had left the Malacanang post), charged before the ombudsman 11 former and incumbent PhilHealth executives with graft, usurpation of judicial functions and grave misconduct. Specifically, for accrediting an "erring" hospital, Cebu's PSH, which cost the health insurance firm at least P90 million, counted at P30 million per month in claims Perpetual Succor shouldn't have collected. PSH, as a corporation, is included in Roque's complaint.
WHY CORRUPTION IS 'REVOLTING.' The PSH case is only one of a number of horror tales of cooperation coming out of PhilHealth, indicating strongly of collusion between some public officials and the recipient hospitals.
Another case that has seized public attention was the accreditation for WellMead Dialysis and Laboratory Center "despite an agency finding that the clinic had filed fraudulent claims for dead patients."
The corruption has been called systemic, long entrenched, and is seen to require a "mafia-like" organization. PhilHealth is oozing with funds: P217 billion appropriated by Congress for the Universal Health Care Law and another P27 billion due from six taxes. Universal Health Care's requirement for 2019 alone, Lacson said last year, was P257 billion.
"When we hear P250 billion being wasted over time, then it is revolting, to say the least, because we're all practically members of PhilHealth," Lacson said.
'PERPETUAL' STAIN. It is unfortunate that PSH is linked to the scandal, one that steals billions of pesos from no less than a public health program.
A source at the local hospital industry told SunStar Saturday, August 29: "The stain may disappear from public view when the fraud is forgotten but whenever the PhilHealth issue comes up, the hospitals that allegedly connived with the firm's officials will also come up. Like a perpetual stain, it won't really go away."
According to the PSH website, Perpetual Succor Hospital is "clearly a Catholic hospital owned and managed by the Sisters of St. Paul of Chartres." It is a "Ministry and Mission in itself."
Roque, in an August 30, 2019 column "Briefing Room" in "Daily Tribune," wrote why he sued PhilHealth officials and Perpetual Succor: "I was unable to shake the feeling that wrongdoing had occurred and there had to be redress."
From the disclosures in the congressional hearings last year and the last few days, the prosecutors may have already found solid evidence and would no longer rely on plain sentiment.