The National Bureau of Investigation (NBI) has filed graft and other criminal charges before the Office of the Ombudsman against officials of a Cebu City hospital for allegedly making fraudulent claims to collect more money from PhilHealth.

NBI files graft raps vs Cebu hospital execs for ‘upcasing’

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By Nancy Carvajal

The National Bureau of Investigation (NBI) has filed graft and other criminal charges before the Office of the Ombudsman against officials of a Cebu City hospital for allegedly making fraudulent claims to collect more money from PhilHealth.

The NBI said four employees of the Perpetual Succour Hospital connived with eight PhilHealth employees in Cebu City for “upcasing,” or the act of filing a claim for a more serious illness so the reimbursement from Philhealth will be bigger.

NBI Director Eric Distor said that upcasing of medical cases has been found to be one of the prevalent method used by health facilities in connivance with some Philhealth employees to defraud the state insurer firm.

The NBI-region 7 team in their report to the Ombudsman stated that “despite the patient’s negative test results for Covid- 19 virus, the hospital intentionally sent a fraudulent claim for reimbursement to Philhealth in the amount of P333,519 bills for a Covid- 19 severe Pneumonia package.

The amount which is ten times higher than the actual amount due to the hospital was “approved and released hastily by Philhealth, the NBI also said.

“A review done on the attachments would have led to Philhealth’s discovery that the patient’s illness falls only under its Updated Medical Case Rate Package for Pneumonia- High Risk for P32,000 only.’’

Charged for alleged violation of the Anti-Graft and Corrupt Practices Act, Code of Conduct and Ethical Standards of Public Officials and Employees, and Malversation of Public Funds were Arlan Granali (acting regional vice president), Dr. Francis Javier (HCDMD division chief), Dr. Joan Tiu-Ayuson (Benefits Administration Section chief), Josette Bacalso (Fiscal Controller), Dr. Reginal Mangubat (Benefits Administration officer), Anecito Ramas Jr. (Social Insurance Officer), Anthonneette Lerios Maamo (Benefits Administration clerk), and Kenneth Aguilar Donalvo (Social Insurance Assistant).

Also charge for conspiracy to commit fraud were; Sr. Brenda Monares, Succour Hospital Management Manager; Gladys Sarmiento; Jayanne Aranas and Gina Misagal.

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POLITIKO / Across the Nation

POLITIKO / Latest News

‘No COVID vaccine, no work’ policy illegal – Tolentino

MANILA – Administration Sen. Francis Tolentino has cautioned employers over plans to impose a mandatory inoculation policy for its personnel before returning to work amid the arrival of the first COVID-19 vaccine shipment in the country.

Tolentino made the remarks amid complaints from various labor groups that some employers and business owners, particularly those in the private sector are allegedly requiring their employees to avail themselves of company-sponsored vaccination activities or be barred in their respective workplaces.

Tolentino stressed that the so-called “No Vaccine, No Work Policy” is illegal under the National COVID-19 Vaccination Program Act of 2021, which was signed into law last week by President Rodrigo Duterte last week.

According to Tolentino, the new law has put in place safeguards to spare Filipinos from additional burden. The COVID-19 vaccine card, a crucial part of the government’s nationwide vaccination rollout, will not be considered a mandatory requirement in educational, employment, and similar government transaction purposes.

Section 12 of Republic Act No. 11525 that COVID-19 vaccine cards “shall not be considered as an additional mandatory requirement for education, employment, and other similar government transaction purposes.”

The provision which was an amendment introduced by Tolentino prior to the law’s passage in the Senate proscribes discriminatory acts that may be directed against non-inoculated persons and which could lead to possible violations of basic human rights.

The Tolentino amendment safeguards students, regular employees, OFWs, and others from discrimination resulting from non-inoculation.

In guarding against possible prejudicial acts, Section 12 mandates that the COVID-19 vaccination should not be made a precondition for entitlement to necessary services or a basis for preferential acts.

“Inoculation should not be a determinant whether a person is fit or unfit for work. Neither should it be made a prerequisite for acceptance in any educational institutions nor in the availment of government services,” said Tolentino.

The senator explained that since inoculation is still not legislated as mandatory in the country, the said provision is a fair and just inclusion to the government’s vaccination program. (JCC)

Videos of abuse taken out of context? Dismissed envoy says case mishandled

Former ambassador to Brazil Marichu Mauro, who was dismissed for supposedly maltreating her helper said Wednesday she was denied due process and her case was “railroaded” and “mishandled.”

In a 5-page statement, Mauro claimed “there were heavy deficiencies committed by the DFA (Department of Foreign Affairs) Hearing Panel.”

“For some reasons, the DFA Hearing Panel totally disregarded the documentary evidence that my lawyers and I have painstakingly gathered, reviewed and submitted to them,” Mauro said.

She added: “The case was railroaded to the point that important pieces of evidence were deliberately not given due attention.”

Mauro was caught on video while assaulting her 51-year old Filipina helper inside the diplomatic residence.

Over the weekend, President Rodrigo Duterte said he has approved the dismissal of Mauro from the Philippine Foreign Service, and the recommended accessory penalties of cancellation of eligibility, forfeiture of retirement benefits, perpetual disqualification of holding public office and bar from taking civil service examination.

Mauro said she was deeply saddened to learn about her dismissal through media reports and that it “pains” her that the penalty was recommended and imposed “despite the explanation and contextualization of what actually transpired.”

“I completely regret the incidents in the videos and the shame it has brought upon the Department of Foreign Affairs… I want to reassure the public that I have made amends and have deeply regretted my behavior,” she said.

“I have asked my kasambahay’s forgiveness, which she has given.”

She went on to claim that she has been treating her helper as a family member as has been in her family’s employ on and off for over 30 years.

“My kasambahay has always considered this a family matter to be resolved within the family. Her silence and refusal to appear before the public despite heavy encouragement to do so is testament to her desire to keep this matter within the family,” she said.

Despite the helper’s refusal to lodge formal charges, Mauro said the still actively pursued the helper and recommended her dismissal.

The diplomat also claimed that the videos were “taken out of context and created a negative public impression” that judged her character.

She also disclosed her plan to bring her case to the court to “obtain an unbiased judgment.”



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