‘Revoke licenses of doctors tagged in insurance fraud’

By Ding Cervantes

CLARK FREEPORT, Pampanga  – A former executive of the Philippine Health Insurance Corp. (PhilHealth) has called for the automatic revocation of the licenses of doctors found guilty of involvement in fraud insurance claims.

In a forum with the Capampangans in Media Inc. (CAMI) here last week, former PhilHealth senior vice president Tito Mendiola expressed dismay over reports that the state health insurance paid P500 million to 10 doctors last year.

“During my term, there have also been questionable claims by some doctors. There were instances wherein those involved charged P16,000 for cataract operations even if they just cleaned the eyes of the patient,” Mendiola said.

The former PhilHealth official said such offenses by doctors deprive the poor members of the agency of funds.

He said he is in favor of a special law crafted especially to curb such anomalies. The law should cover automatic revocation of license of doctors found guilty of the offense, he added.

Last week, PhilHealth president and chief executive officer Alex Padilla said that of the 10 doctors, nine were opthalmologists.

Padilla said the PhilHealth is reviewing documents covering these claims for “possible badges of fraud.”

Padilla identified two of the claimants as Raymond Evangelista and David Harold Gosiengfiao, owners of Quezon City Eye Center and Pacific Eye Institute in Makati City, respectively.

He said the two denied the anomalies in their insurance claims.

He said another eye doctor, who passed the medical licensure exams only last year, was paid P36 million. He refused to identify the doctor.

Padilla said he would request the Professional Regulation Commission to cancel the licenses of those involved in the fraudulent claims.