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PH health insurance company withdraws dialysis center’s accreditation over alleged ghost dialysis scam

The Philippine Health Insurance Corporation (PhilHealth) has withdrawn the accreditation of WellMed Dialysis & Laboratory Center Corporation, a company which allegedly charged the government insurance company with fraudulent transactions. This was announced in PhilHealth’s Facebook page today.

Two former WellMed employees, Edwin Roberto and Liezel Santos, alleged that the health center’s owner instructed them to charge PhilHealth for dialysis treatments, even if the patients were already dead. Roberto called the unethical practice “ghost dialysis.”

PhilHealth said in its statement today that it withdrew the dialysis center’s accreditation “in view of the fraudulent claims for dialysis services filed on behalf of deceased patients.”

“We reiterate that prior to this, PhilHealth has ceased paying the said dialysis center for their claims,” it added.

“We advise our members and their qualified beneficiaries who are availing of WellMed’s services to transfer to other accredited facilities to ensure continuous availment of their PhilHealth benefits.”

The announcement comes two days after WellMed owner Bryan Sy was released by the National Bureau of Investigation (NBI) after being detained for seven days.

The NBI arrested him early last week without a warrant of arrest when he visited the bureau’s office after he was subpoenaed. Sy was charged with fraud through falsification of public documents but was released on Sunday after posting a bail of PHP72,000 (US$1,382), reported The Philippine Daily Inquirer. 

His former employees, whistleblowers Roberto and Santos, were also arrested and charged with the same crime. The NBI said the two had to be charged first before they could be turned into state witnesses.

Roberto and Santos said they first told PhilHealth about WellMed’s questionable practices in 2017, but the government insurance company was allegedly slow in investigating the case. The two also alleged that they were receiving threats from WellMed’s owner and that PhilHealth couldn’t provide them protection.

According to an exposé published by Inquirer, Wellmed was not the only health care provider that was defrauding PhilHealth. The newspaper also reported that some hospitals have been overcharging PhilHealth, which led it to lose a total of PHP154 billion (US$2.996 billion) since 2013.

PhilHealth officials have tendered their resignation after President Rodrigo Duterte ordered them to quit because of the controversy. Malacañang has yet to accept their resignations.

Duterte is eyeing a certain Dr. Jaime Cruz to become the new president of PhilHealth. Cruz is a board member of the Philippine Chinese Charitable Association Incorporated, which manages the Chinese General Hospital and Medical Center in Sampaloc, Manila. As of writing, Cruz has yet to accept Duterte’s offer.

This article, PH health insurance company withdraws dialysis center’s accreditation over alleged ghost dialysis scam, originally appeared on Coconuts, Asia's leading alternative media company. Want more Coconuts? Sign up for our newsletters!