The Philippine Health Insurance Corporation said it is implementing a “temporary suspension of payment of claims” against healthcare providers that are “subject of investigations pertaining to fraudulent” claims.
“ a payment preventive measure against HCPs that are subject of investigation based on the credible and verifiable report by the Corporation or other duly authorized government agencies, owing to apparent and probable presence of fraudulent act, unethical practices, and /or abuse of authority,” it added.
“Fraud control is a basic tenet in managing funds. Hence, PhilHealth finds it imperative to implement measures to ascertain the security and sustainability of funds entrusted to it,” she added.
The approach is sweeping, all claims are considered fraudulent unless the hospital show proof that it's not.
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