Philippine Health Insurance Corporation (PhilHealth), a state healthcare insurer affiliated with the Department of Health, is embroiled in a Senate probe involving thousands of fraudulent claims and mismanagement of funds.
In the senate hearing, PhilHealth’s anti-fraud officer Thorrsson Montes Keith said that he resigned out of “disgust” and alleged mafia connections within the agency. Keith also called Health Secretary Dr. Francisco Duque III “the godfather of the mafia” because he approved the appointments of the alleged mafia members in PhilHealth.
The investigation came after PhilHealth officials were accused of pocketing US$310 millionthrough a program called Interim Reimbursement Mechanism (IRM). IRM can bypass usual procedures, allowing its regional offices to speed up the reimbursement process for insurance claims to healthcare facilities during “fortuitous circumstances.”