By Hannah L. Torregoza

Senator Richard Gordon on Thursday said he is eyeing the creation of a special unit within the Philippine Health Insurance Corp. (PhilHealth) that would be focused on investigating fraudulent health insurance claims.

Gordon said he plans to file a bill establishing this special unit in the PhilHealth in the 18th Congress.

The senator said the creation of the special unit will prevent clinics and doctors from deceiving the administrator of the National Health Insurance Program.

“One of the bills I will file is to create a special unit to investigate insurance fraud within PhilHealth,” Gordon said at the Kapihan sa Senado forum.

“Dapat may special unit dun, tinitignan lang niyan kung me fraud, para mabilis (There should be a special unit there that would check for fraud, to make it faster),” he stressed.

Gordon said PhilHealth cannot always rely on the National Bureau of Investigation (NBI) or the Philippine National Police (PNP), or other investigating agencies to handle fraudulent claims as these bodies are also handling other cases.

“Ire-rely mo sa NBI, busy ang NBI. Sa pulis, busy ‘yan. Dapat may unit within PhilHealth, independent na iimbestigahan ‘yung fraudulent claims, (If you rely with the NBI, the NBI is busy, the police are busy. So there should be a unit within PhilHealth that will independently investigate fraudulent claims),” he said.

PhilHealth earned flak over its alleged involvement in the so-called ‘ghost dialysis’ scheme at WellMed Dialysis Center. It canceled WellMed’s accreditation following the scandal.

President Rodrigo Duterte had ordered then PhilHealth president Roy Ferrer and other officials of the agency to resign following the controversy.

Duterte appointed retired army general Ricardo “Dick” Morales and replaced Ferrer. Morales’ appointment came as PhilHealth gears up for the implementation of the Universal Health Care (UHC) law.