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PhilHealth - Results of Initial Investigation on Premium Payment Diversion Scheme

Based on the initial investigation conducted, it has been established that the cheques for the premium payments of Accenture Inc. did not reach PhilHealth. However, these cheques were encashed in at least two branches of Metrobank in Batangas.

To ensure non-detection of the irregularity, the supposed premium payments were illegally uploaded in the Treasury Database and posted in the individual accounts of the Accenture employees, to make it appear that their health insurance premium contributions have actually been remitted, and will therefore make them eligible for benefits availment.

The fictitious crediting of premium payments to Accenture, Inc. in the Treasury and Membership Databases happened from October to December 2010, and from February to September 2011 and involves about P114 million. However, ongoing investigation found that the initial attempts of these anomalous transactions were started in late 2009. Management continues to conduct in-depth investigations to determine and confirm these observations.

PhilHealth officials are filing the necessary administrative charges against five (5) officers/supervisors and personnel of its Information Technology and Management Department, suspected to have been involved or have indirectly contributed to the commission of this anomalous transaction. Likewise, Accenture, Inc. have been billed for the amount corresponding to the diverted premiums and the amount of availment of their employees for the particular periods.

“At the same time, we continue to work closely with the National Bureau of Investigation and with the Anti-Money Laundering Council (AMLC) for the filing of the necessary criminal charges against persons or institutions that will be found guilty of colluding in these transactions. We have been made aware that Metrobank has coordinated with appropriate authorities as part of their own investigations.

Let me assure our members that we are doing this in the spirit of good governance. We want to make sure that this will not happen again, that is why we are bent on going after those who are truly accountable”, Dr. Eduardo Banzon, PhilHealth President and CEO firmly concluded. (PhilHealth)