The NBI in Northern Mindanao has started an investigation into suspected fraudulent health insurance claims that cost the PhilHealth at least P200 million annually in the region alone.
CAGAYAN DE ORO CITY, Philippines – The National Bureau of Investigation in Northern Mindanao has started an investigation into suspected fraudulent health insurance claims that cost the Philippine Health Insurance Corporation at least P200 million annually in the region alone.
Lawyer Ian Alfredo Magno, PhilHealth legal division head for Northern Mindanao, said PhilHealth has been paying an average P4 billion a year in insurance coverage in the region, and “statistically, 5% of those claims are fraudulent.” “The NBI will be working hand-in-hand with PhilHealth in the investigation of these criminal acts. We will endeavor to ferret out the truth, and we will definitely be filing cases,” Bernales said.
Since 2019, the PhilHealth regional office has filed 183 administrative cases for fraudulent claims. Magno said 113 of the cases were filed in 2019, 35 in 2020, 28 in 2021, and seven in 2022. But no criminal case has been filed against suspects because the PhilHealth central office has yet to decide on the administrative cases, according to Magno.
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