AT A GLANCE:
[1] Perpetual Succor Hospital of Cebu Inc. answers the SunStar Explainer of August 29: It calls the revival of the 2011 incident "unfortunate" and blames failure of PhilHealth to inform the Court of Appeals of its new policy on penalties.
[2] The hospital -- through its executive chief officer Sister Zeta Caridad Rivero, a member of the Sisters of St. Paul De Chartres Congregation that owns and runs PSH -- has flatly denied that PSH conspired with PhilHealth officials to avert its suspension and save about P90 million income. In an August 31 letter to SunStar, she cites the content of the hospital's August 24, 2020 counter-affidavit, filed by Atty. Jobelle Rae T. Montecillo, to the August 29, 2019 lawsuit of Harry Roque against PhilHealth directors and PSH as a corporation.
[3] Sister Zeta in counter-affidavit calls the accusation "absolutely false, unfair and unjust," adding that SPC and the SPC sisters "abhor any unjust enrichment scheme, for that is against our vow of poverty."
INTO VORTEX OF NATIONAL CONTROVERSY. The separate Senate and House committee hearings on the alleged multibillion-peso fraud at the state insurance company PhilHealth have dragged Perpetual Succor Hospital in Cebu City to a national controversy. Again.
Last August 18, 2019, in a similar Senate hearing on PhilHealth irregularities, Senator Panfilo Lacson cited the case of PSH to show that some foul deeds were going on at the insurance firm.
This year, while the country is still grappling with the Covid-19 public health emergency, new hearings on the PhilHealth scam have brought up the PSH case once more on the national stage. The dirty linen includes the August 29, 2019 complaint of Harry Roque, as a private lawyer at the time, before the ombudsman against 11 former incumbent and present PhilHealth officials and PSH as a corporation.
What prompted Roque's litigation was the same as Lacson's beef last year and the cause of the House committees' fury in the current hearings: namely, the alleged "machination" of the PhilHealth board favoring PSH by reversing the decision of the Court of Appeals.
ROQUE'S GRIPE USED CONGRESS. The "dossier" on Perpetual Succor is lumped with such disclosures at the hearing as a "mafia" poaching on PhilHealth money and scams that involved fictitious dialysis and other medical procedures for which the insurance firm paid millions of pesos.
Raked up again by witnesses and lawmakers at the hearings are PSH's alleged offenses: (1) alleged "fraud" in extending the hospital stay of two patients; and (2) alleged "machination" to reverse an earlier PhilHealth board ruling that found the hospital guilty of prolonging the stay of two patients: from P10,000 fine and suspension of three months to P100,000 without the suspension that would've lost PSH P90 million or P30 million a month.
EXTENDED STAY. The hospital contends there was no fraud on the stay of two patients: One was given "May Go Home" notice July 22, 2011 but left only on July 23. Another was notified February 3, 2011 but left only on February 27. The patients extended their stay but PhilHealth investigation and court ruling construed it that "PSC extended their stay."
The CA affirmed PhilHealth's board decision on August 9, 2017 and rejected PSH's motion for reconsideration March 8, 2018. PhilHealth issued a writ of execution starting January 21, 2019.
Before that day would come, Sister Rivero wrote a letter dated December 10, 2018, raising concerns on the effects of the penalty, including: "what will happen to the open-heart, obstetric, and other surgical cases"; impact on government employees and their dependents, pensioners and the patients who go PSH for hemodialysis, "and besides, the P79.2 million unpaid claims the insurance firm owed the hospital as of 2019."
On January 10, 2019, 11 days before the suspension was to start, the PhilHealth board changed its ruling, raising the fine to P100,000 but removing the suspension.
TIMELINE ON REVERSED RULING. The turnaround by the board is what has bugged the lawmakers at the hearings in 2019 and 2020 and prompted Roque to litigate. The root of controversy: "Why for heaven sake did Philhealth reverse the CA ruling?"
Sister Rivero said the sequence of events was "just recently" brought to PSH's attention:
[1] The PhilHealth board adopted on December 5, 2017 the new policy of "imposing the maximum fine instead of suspension or revocation of accreditation for administrative offenses of institutional health-care providers."
[2] The St. Paul sisters, through Sister Rivero, wrote the letter of appeal on December 10, 2018, or one year after the policy was adopted.
[3] The CA rejected PSH's motion for recon on March 8, 2018, with the court apparently not informed by any of the parties about the board's change of policy.
[4] On January 10, 2019. the PhilHealth board made the controversial turnaround.
OTHER CIRCUMSTANCES. The timeline may be used to dissipate the charge of collusion between insurer and health-care provider. But it does not remove the suspicion that the board adopted its December 5, 2017 policy to go around the CA's earlier August 9, 2017 ruling.
And there may be other circumstances that a full-blown investigation or hearing, which has not yet happened, may disclose.
And it's not helping Perpetual Succor's case to be thrown into other cases that make the PhilHealth scandal, to an outraged public, stink to high heavens.
The St. Paul sisters reaffirm their vow of poverty. But with the people's suffering being pushed to near-intolerable level, that unavoidably hits some chord of irony.