THE Office of the Ombudsman Visayas dismissed all cases related to Covid-19 claims against several officials of the Philippine Health Insurance Corp. (PhilHealth) 7, citing lack of probable cause and evidence, as well as lack of merit.
The National Bureau of Investigation (NBI) 7 filed the criminal and administrative complaints against them during the height of the pandemic in October 2020 and February 2021.
It charged the Philhealth 7 officials with violating Section 3 (e) of Republic Act (RA) 3019, or the Anti-Graft and Corrupt Practices Act; malversation of public funds through falsification of public documents, a violation under Article 217 of the Revised Penal Code; violation of Section 4 of RA 6713, or the Code of Conduct and Ethical Standards for Public Officials and Employees; and gross and grave misconduct.
It also charged them with violating the Revised Administrative Code for Dishonesty, neglect of duty and misconduct, incompetence in the performance and inefficiency in official duties, and conduct prejudicial to the best interest of the service.
In the complaints, NBI 7 said the respondents were involved in fraudulent activities with officials and employees of Perpetual Succour Hospital and Chong Hua Hospital.
Fraudulent activities included the “upcasing” or claiming for a related illness or procedure of higher severity or complexity to gain higher benefit payment.
Philhealth 7, in a statement sent to SunStar Cebu, said the resolution issued by the deputy ombudsman in Visayas stated that the NBI 7 failed to present substantial evidence that the respondent was negligent in the function of their duty.
PhilHealth 7 said its officers and employees abided by the guidelines in processing claim documents based on published circulars of the state health insurer’s head office.
The respondents were Arlan Granali (acting regional vice president), Dr. Francis Javier (Health Care Delivery Management Division chief), Dr. Joan Ayuson (Benefits Administration Section chief), Josette Bacalso (Fiscal Controller), Dr. Reginald Mangubat (Benefits Administration officer), Anecito Ramas Jr. (Social Insurance Officer), Anthonneette Maamo (Benefits Administration clerk), and Kenneth Donalvo (Social Insurance Assistant).