GENERAL SANTOS CITY — The Philippine Health Insurance Corp. in Region 12 (Soccsksargen) (PhilHealth-12) said it is about to complete an investigation centering on a physician and several hospitals suspected of engaging in fraudulent health insurance claims.
Lawyer Jusen Lubaton, PhilHealth-12 legal services chief, said their fact-finding investigation focuses on the alleged connivance by a Koronadal City-based doctor with at least three hospitals to defraud the agency through falsified claims.
Lubaton said the doctor has gained traction these past months and they are now looking into the extent of the illegal activity, he said.
“This is a big case. We are trying to finish our investigation because many are involved,” he said in a press conference in Koronadal City on Monday.
Lubaton declined to identify the erring doctor and the involved hospitals pending the completion of the probe but hinted that these were already the subject of previous media reports.
During the deliberation for PhilHealth’s budget last January, Senate President Vicente Sotto III raised the alleged illegal practices of Dr. Mark Dennis Menguita, a neurologist based in Koronadal City.
Sotto said Menguita reportedly seeks legitimate PhilHealth members to be his patient so he can collect medical insurance from the agency through fraudulent means.
PhilHealth confirmed then that their regional office already started its investigation on Menguita.
Lubaton said they already submitted the initial fact-finding reports regarding the case these past months to their central office for review and further investigation.
“As far as I can remember, we already recommended at least two (hospitals) for the filing of initial cases, including this one famous person here,” he said.
Lubaton added that the formal charges would be filed by the fact-finding and enforcement division of PhilHealth. (PNA)