OMB-C-2024-0904
critical
High-Profile
Whistleblower
Confidential
Fraudulent accreditation of ghost dialysis centers and payment of false claims — PHP 632M in fraudulent reimbursements
Case Stage Progress
Stage 18 of 22: filing decision
Case Information
Complaint IDOMB-2024-0031
Docket NumberOMB-C-2024-0904
Date Received3/5/2024
Sourcewhistleblower
Case Typeplunder
Statusfiled sandiganbayan
Prioritycritical
Priority Score94
Completeness91%
RegionNCR
Amount Involved₱632,000,000
Primary Respondent
NameVPres. Alejandro Bañez, Dir. Carmela Uy (Fictionalized)
PositionVP for Health Finance / Director for Accreditation
AgencyPhilippine Health Insurance Corporation
Rankdirector
Gov't Branchgocc
ComplainantCONFIDENTIAL INFORMANT (PhilHealth Insider)
Complainant Typeconfidential informant
Allegations & Details
Nature of Complaint
Fraudulent accreditation of ghost dialysis centers and payment of false claims — PHP 632M in fraudulent reimbursements
Alleged Acts or Omissions
Accreditation of fictitious dialysis clinics, approval of fraudulent medical claims from non-existent patients, receipt of kickbacks from medical syndicates, falsification of accreditation documents, conspiracy with organized crime networks
Date of Incident2021-01-01
Place of IncidentPhilHealth Central Office, Pasig City
ProjectPhilHealth Dialysis Program