Cebu City hospital: No fraud involved in COVID-19 claim

By: Morexette Marie B. Erram - CDN Digital | October 30,2020 - 10:32 AM

CEBU CITY, Philippines – A hospital in Cebu City denied allegations that some of their officers and employees were involved in fraudulent activities involving public funds.

Perpetual Succour Hospital Inc. (PSHI) in Cebu made this pronouncement after four personnel from their Financial Management and Services (FMS) were among those facing complaints before the Office of the Ombudsman in the Visayas.

The cases were filed by the National Bureau of Investigation in Central Visayas (NBI-7) last Thursday, October 29, 2020, after their fact-finding team alleged that the hospital, together with some officials from the Philippine Health Insurance Corp. in the region (PhilHealth-7), connived in upcasing a deceased patient’s case to severe coronavirus disease 2019 (COVID-19).

READ MORE8 PhilHealth officials, 4 hospital workers face complaint over ‘fraudulent’ COVID-19 claim

However, PSHI, in a statement sent to the media on Friday, October 30, and signed by its legal officer and lawyer Jose Ray Bael, assured the public that there were no irregularities made in processing the claims of the patient, referred to as Patient X.

“PSHI is strongly confident that the PhilHealth claim for Patient X is above board as it was based on medical diagnosis of competent and respected medical professionals,” portions of the statement read.

“The claim was supported by medical records submitted to PhilHealth and passed scrutiny and applicable criteria set by PhilHealth circulars and guidelines,” it added.

PhilHealth -7, in an earlier statement, also made the same assurance that officials from their firm have not violated any policies in processing Patient X’s COVID-19 claims.

Both PhilHealth-7 and PSHI took a swipe against NBI-7’s decision to publicly announce its decision to file complaints before the state’s anti-graft and corrupt office.

READ MORE: PhilHealth-7 welcomes NBI investigation

“It is unfortunate, however, that NBI-7 intended a public announcement of the filing of cases against four PSHI officers and personnel for alleged fraudulent PhilHealth claim before they are furnished a copy of the alleged complaint and given the opportunity to answer the accusations,” the hospital said.

PSHI added that they will be filing a ‘detailed factual and legal counter-statement’ before the Ombudsman to prove their innocence ‘and total absence of fraud or malice in the preparation and submission of the PhilHealth claim for Patient X’.

NBI-7, in their complaints, stated that Patient X, who was admitted to Perpetual Succour Hospital last May, died due to non-COVID-19 pneumonia with a pre-existing medical condition (stage four cancer).

However, they said that the patient’s living relatives received information from PhilHealth-7 that severe COVID-19 claims amounting to a total of P333,519 were credited to the hospital despite the fact that he succumbed to regular pneumonia, and tested negative for SARS-CoV-2.

Claims for regular or non-COVID-related pneumonia, according to PhilHealth’s Circular No.9, Series of 2020, was at P32,000.

In the meantime, NBI-7 announced that they are investigating over 100 cases of possible fraudulent COVID-19 claims in Central Visayas.

/bmjo

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TAGS: COVID-19 claim, fraud, fraudulent COVID-19 claim?, Hospital: No fraud involved in COVID-19 claim, NBI-7, Perpetual Succour Hospital, PhilHealth-7

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