2.7 million OFWs lost their premiums to another PhilHealth fraud scheme, ex-official bares

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Metro Manila (CNN Philippines, September 2) — More than 2 million overseas Filipino workers have lost their premiums to another fraudulent scheme in the embattled Philippine Health Insurance Corp, a former official of the agency bared Wednesday.

During the probe of the House Committee on Public Accounts and the Committee on Good Government and Public Accountability, former PhilHealth auditing system specialist Ken Sarmiento said that they have identified at least 2,726,453 OFWs including their dependents from 2015 to 2017 alone who lost their contributions due to "damaged, cancelled, or lost" receipts.

The cumulative losses from the premiums amounted to ₱1.3 billion, according to Sarmiento, who had coordinated with the Philippine Overseas Employment Administration under his line of work.

Sarmiento said that a "sharing scheme" exists between representatives of hiring agencies and "marketers" who sell fake PhilHealth receipts to victimize OFW members.

He said PhilHealth receipts have been recycled and falsified by hiring agencies, with control number series sourced from different PhilHealth offices nationwide. Sarmiento added this operation may have been occurring before he took his position in 2015.

"Control numbers [of the receipts] were sourced from different areas of the country, from as far as Batangas, Pampanga, Iligan," he added.

He added that more than 40 potential members of a "syndicate" are involved in the scheme.

"We discovered about 40 plus of them and we documented about 12 to 13, so fair to say na merong pang sindikato (that there is a syndicate behind this)," said Sarmiento. He did not say if it is connected to the "mafia" syndicate within PhilHealth which has been the target of congressional probes over the past weeks.

As of 2018, at least 48 land-based hiring agencies were under investigation, 12 of which have affidavit complaints filed with the National Bureau of Investigation.

Sarmiento said he was removed from his post through the "collective effort" of Dennis Mas, former Regional Vice President in the National Capial Region, former COO John Basa, and other board members Narisa Sugay and Gilda Salvacion Diaz after he submitted his 2015 report.

"These are seasoned technocrats...in a way I was isolated and removed from office so that the investigation will stop," he said.

Sarmiento also claimed that he reported his findings to Mas' office, but these were not immediately acted upon. Mas now serves as Senior Vice President for the Management Services Sector of the agency.

There were no immediate comments from Philhealth officials named by Sarmiento except for Mas who was also at the hearing.

Mas claimed that Sarmiento was only “reassigned” to another position subject to the approval of the latter’s subordinates. He also said his office did not immediately receive Sarmiento's report which was supposedly submitted to him in September 2015 but which he learned about only in November, or two months later. He added that a fact-finding investigation was launched, but did not elaborate on the findings or actions taken.

The joint House panel wrapped up on Wednesday its investigation on the corruption issues of PhilHealth after holding nine committee hearings on the matter.

Public Accounts committee chair Mike Defensor of Anakalusugan Partylist said they will file plunder cases against the concerned PhilHealth officials before the Department of Justice after tackling issues ranging from OFW collections, the agency's IT budget, case rate system, and the controversial IRM scheme.