PhilHealth in politics as usual

ENQUIRY
DEMAREE J.B. RAVAL

PhilHealth in politics as usual
Sunday, 01 10, 2010

Resolution No. 8646 of the Commission on Elections (Comelec) mandates that effective Jan. 10, 2010, pursuant to Section 261(h) of the Omnibus Election Code, there shall be no transfer of officers and employees in the civil service.

Dr. Rey Aquino, president and chief executive officer of Philippine Health Insurance Corp. (PhilHealth), thinks that by issuing a special order re-assigning the regional assistant vice presidents of PhilHealth on Jan. 8, 2010, he can go around this prohibition of the Comelec. But that is exactly what he did last Friday at or around 4 p.m., when he distributed by e-mail PhilHealth Special Order No. 16, dated Jan. 8, 2010 re-assigning 26 PhilHealth officers to different regional postings “effective immediately.”

Over at the Kapihan sa Sulo yesterday morning, a frantic PhilHealth officer brought this matter to our attention, prompting Sen. Nene Pimentel to comment that any personnel action made so close to the start of the prohibition date is always subject to suspicion for its political motives, especially the matter of placing an officer or employee to a station where the latter could possibly be more of help to further the candidacy of one’s favored candidates.

PhilHealth figured prominently in the 2004 and 2007 elections, where its resources and personnel were used to the advantage of candidates of the Arroyo administration. Now, Aquino’s move re-assigning key officers signals a reprise of this electoral offense committed in past elections.

But the affected PhilHealth officers have put forward other reasons that could have goaded Aquino to issue Special Order No. 16.

For one, they say that it was issued in evident bad faith, and simply meant to harass and oppress them. The affected officers are opposed to the implementation of a Simplified Reimbursement Scheme for Provider Claims (SRS) drawn up by Aquino. The SRS requires concerned PhilHealth officers to certify on the disbursement voucher the completeness and validity of the claim as well as payment of 75 percent of the amount being claimed by the hospital immediately upon initial verification of the member’s eligibility to avail of PhilHealth benefits but even before the actual review and evaluation of the completeness of documentary requirements, the appropriateness of medical procedures and the correctness of the amount claimed. The oppositors to the SRS point out that such a scheme might result in hundreds of millions in financial losses to PhilHealth due to unwarranted payments of hospital claims that may be found later on to be incomplete, defective, irregular or fraudulent.

Did Aquino resort to re-assignment to silence the oppositors to the implementation of the SRS? Aquino may have issued the order of re-assignment under the pretext of advancing and promoting public interest. But such indiscriminate and whimsical exercise of the power to re-assign employees in PhilHealth smacks of bad faith.

On Nov. 18, 2009, the Commission on Audit issued an opinion stating that SRS will circumvent existing government rules and regulations on claims against government funds, as the payment is to be made even before the review and evaluation of the claims. Despite the CoA opinion, Aquino insists on the implementation of the SRS. The oppositors are speculating on why Aquino, a medical doctor, is very passionate in implementing the SRS. Indeed, why should a scheme obviously grossly disadvantageous to the financial viability of PhilHealth be pushed even by its president and chief executive officer?

Aquino may have also overlooked the fact that the affected officers of PhilHealth — all of them Career Executive Service Officers (CESOs) — enjoy security of tenure, and their re-assignment is violative of the Career Executive Service Board (CESB) guidelines on the Reassignment and Transfer of CESOs. CESB Special Order No. 6-2006 mandates that “The re-assignment of CESOs shall be effected through office orders issued by duly authorized official/s at least 30 days prior to its effectivity reckoned from the date of receipt of the said office order by the CESOs concerned...”

Worse, Aquino may have violated the right to security of tenure of the affected PhilHealth officers. The Supreme Court has repeated in many cases that the mantle of protection of security of tenure as a constitutionally guaranteed feature of our Civil Service System extends not only against removals without cause but also against uncontested transfers which are tantamount to removals. The PhilHealth officers have been removed from their stations without their consent.

PhilHealth Special Order No. 16 of Aquino provides that it shall take effect immediately. This patent disregard by Aquino of the mandatory 30-day notice requirement set forth under the CESB circular is clear violation of the right of the affected PhilHealth officers to procedural due process.

To be charitable about it, Aquino may have unwittingly put the Arroyo administration in a bad light. The timing in the issuance of Special Order No. 16 is bad; the circumstances surrounding its issuance are worse; the violations of law committed are patent; and, the consequences of its issuance will hound the Arroyo administration no end in the course of the election period.

Many years ago, we had a hand in the crafting of the law creating the Philippine Health Insurance Corp. of which Sen. Edgardo Angara was the principal author and sponsor. Appropriately, Angara has been dubbed the “Father of PhilHealth.” It pains us so much to see that PhilHealth is being used and abused the way Aquino has used and abused PhilHealth and its officers — for political and other purposes? — through his patently illegal and invalid Special Order No. 16.

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