Ophthalmologist claims PhilHealth exec tried to extort ₱7M from him

enablePagination: false
maxItemsPerPage: 10
maxPaginationLinks: 10

Metro Manila (CNN Philippines, September 5)— An ophthalmologist accused a senior vice president of the state health insurance agency of attempting to extort ₱7 million from him so his claims can be released.

Dr. David Gosengfiao said Thursday that Eduardo Asuncion, who was then sitting as Philippine Health Insurance Corporation (PhilHealth) senior vice president for legal affairs, told him to pay up so his claims can be paid and the charges filed against him withdrawn.

Nakipag-meeting siya sa amin. And then sabi niya sa akin ... ‘Di ka babayaran, matagal pa ‘yan. In fact magfa-file na kami ng mga criminal charges against sa iyo,” Gosengfiao said during the Senate’s probe n the fraudulent claims filed with PhilHealth.

[Translation: He met with us. And then he told me … you won’t be paid, that would take a long time. In fact, we’re filing criminal charges against you.]

Gosengfiao said he has filed a complaint with the PhilHealth against Asuncion. This was confirmed by Valerie Jolero, then the state health insurer’s corporate secretary, who added that Gosengfiao also accused Asuncion of asking ₱7 million in two installments.

Asuncion was not present during the hearing.

Gosengfiao also said that PhilHealth is also “defrauding” doctors by junking claims made by patients, preventing them from collecting denied claims and filing charges against them.

He said the charges against him are “illegal” as they are only based on alleged violations of the code of ethics of the Philippine Association of Ophthalmology. He accused the group of having an axe to grind against him as he significantly lowered prices of eye checkups and operations.

Rodolfo del Rosario Jr., PhilHealth senior vice president, said Gosengfiao has been slapped with a ₱2.6-million fine in connection with cases filed against him before the state health insurer.

CNN Philippines’ Xave Gregorio and Paolo Barcelon contributed to this report.