'PhilHealth Paid P500 Million to 10 Doctors'

The head of the Philippine Health Insurance Corp. (PhilHealth) recently admitted that the state-owned agency has paid doctors about P500 million in health insurance benefit claims to just 10 medical professionals last year.

“These are the top 10 claimants. Of the 10, nine are eye doctors,” PhilHealth president and chief executive officer Alex Padilla told the Kapihan sa Serye forum in Quezon City.

He said Philhealth suspected something irregular when the claims ballooned. Philhealth staff are gathering documents involved in the settled claims for possible instances of fraud.

Two of the claimants were identified as Raymond Evangelista and David Harold Gosiengfiao, owners of Quezon City Eye Center and Pacific Eye Institute in Makati City, respectively.

Another eye doctor, who reportedly passed the professional licensure exams only last year, was paid P36 million in claims.

According to Padilla, Philhealth paid P78 billion in insurance benefits. He added P7 billion was paid for patients with pneumonia, P3 billion for dialysis treatment, P3 billion for cesarian procedures and P2 billion for cataract operation.

But he said some eye doctors were performing cataract removal to claim higher Philhealth payments even such procedure was not necessary.

“I pity the patients, one of them went blind after the procedure,” Padilla said.