The Court of Appeals (CA) has urged healthcare institutions not to resort to unscrupulous methods just to avail of the benefits being provided by the Philippine Health Insurance Corp. (Philhealth).
methods just to avail of the benefits being provided by the Philippine Health Insurance Corp. .
The appellate court made the reminder as it denied the petition filed by Dr. Alberto Castro seeking to set aside the April 11, 2019 decision of the Philhealth board affirming the October 26, 2018 decision of the arbitration office of Philhealth finding him guilty of 17 counts of administrative offense of breach of warranties of accreditation under Republic Act 7875 or the National Health Insurance Act.
After several days of investigation, Abbas found out that Castro along with several other doctors were engaged in the recruitment of patients for cataract operations, which is detrimental to the interest of Philhealth.Acting on the recommendation of Abbas, Philhealth’s Finding Investigation and Enforcement Department conducted its own probe.
The FFIED recommended the filing of a formal complaint against Dr. Castro and Quezon City Eye Center for violation of Philhealth Circular Nos. 17 and 19 Series of 2007. However, the Philhealth declared that it was highly questionable that patients were transported for free in going to and from Quezon City Eye Center, when the operation could have been performed in one of the government hospitals in Bulacan or in Monte Falco Hospital where the petitioner has a clinic.
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