THE Adventist Hospital-Cebu, on Friday, July 2, 2021, said it is “disheartened” by the announcement made by the National Bureau of Investigation (NBI) 7 against the hospital relating to an alleged Covid-19 claims anomaly.
“We are disheartened that the NBI 7 released a public announcement on the alleged PHIC (Philippine Health Insurance Corp.) claims and connivance with the said agency without furnishing us a copy of the formal complaint and giving our staff and physician the opportunity to refute the accusations against them,” reads a portion of the official statement released by the Adventist-Hospital Cebu on July 2.
The hospital said had the attending physician been given the opportunity to explain the clinical/medical arrangement, the involved physician could have “strongly shed light to the investigation.”
Sought for comment, NBI 7 Director Rennan Augustus Oliva said subpoenas were sent to all those being investigated to shed light on the issue.
“That is our SOP (standard operating procedure) as part of due process in all our investigations under our mandate,” he said in a text message.
Among the hospital officers and employees facing various charges, after the NBI 7 filed raps before the Office of the Ombudsman-Visayas on June 29, are Dr. Michelle Jay Francisco-Napigkit, attending physician; Cefriano Julian Jr., chief of the patient business department; Ma. Kenneth La Sage, clerk, PhilHealth section; Dicchel Grace Napigkit, billing clerk; Red Ford Gargarila, billing clerk; and Romeo Rando Jr., registered nurse.
On the other hand, the PhilHealth 7 officials facing charges are Arlan Granali, the former acting regional vice president; Francis Javier, division chief-HCDMD; Joan Tiu-Ayuson, medical specialist IV/section head of the Benefits Administration Section (BAS); Josette Bacalso, fiscal controller IV; Anecito Ramas Jr., social insurance officer 1; Anthonneette Maamo, BAS clerk III; Nina Christine Lunday, BAS social insurance officer 1, and Kenneth Donalyo.
They are criminally charged with alleged violation of Section 3 of Republic Act (RA) 3019, or the Anti-Graft and Corrupt Practices Act, and alleged malversation of public funds or property penalized under Article 217 of the Revised Penal Code.
Aside from these charges, Granali, Javier, Tiu-Ayuson, Bacalso, Ramas, Jr., Maamo, Lunday, and Donalyo were also administratively charged with violating the Revised Administrative Code of 1987 and violating RA 6713, or the Code of Conduct and Ethical Standards of Public Officials and Employees, while additional charges were filed against Francisco-Napigkit of the Adventist Hospital for allegedly issuing false medical certificates.
Oliva earlier said the NBI 7’s basis for filing these charges was their findings in their investigation involving a P333,519 Covid-19 claim for a deceased patient who tested negative for Sars-CoV-2 in his RT-PCR test.
The Adventist-Hospital, however, said their hospital staff performed their responsibilities in accordance with the updated PhilHealth guidelines.
It said that they are certain that their PhilHealth Covid-19 claims went “through a stringent process in strict conformance to the criteria and guidelines of PhilHealth.”
The Adventist Hospital said once they receive the official copy of the complaint from the Office of the Ombudsman Visayas, they will file the necessary counter statements to prove their innocence and total absence of malice in the PhilHealth claims.
NBI 7 earlier said the patient involved was a certain Ervin Gayrama, a retired bank employee and PhilHealth member who was confined at the Adventist Hospital Cebu on May 27 to 28, 2020, due to cough and shortness of breath.
Oliva earlier said Gayrama’s initial diagnosis was “ambulatory” and “acute respiratory failure secondary to pulmonary tuberculosis.”
Gayrama died at the hospital on May 28, 2020.
Gayrama’s attending physician Francisco-Napigkit, Oliva said, then issued his death certificate with the underlying causes as “Covid pneumonia probable, severe; antecedent cause: septic shock secondary to Covid pneumonia, and acute kidney injury secondary to Covid pneumonia probable as an underlying cause.”
He said Gayrama’s initial antibody test result was already available and on June 3, 2020, his negative result for the RT-PCR test was released by the Vicente Sotto Memorial Medical Center.
Despite these, Oliva said, Gayrama’s death certificate was forwarded to the Office of the Civil Registrar in Cebu City with “Covid pneumonia probable, severe” as cause of death, on June 8, 2020 and seven days after, on June 15, the Adventist Hospital officers prepared the PhilHealth claim documents and used the alleged false death certificate as basis when they submitted it to PhilHealth and continued to claim the P333,519 benefit package. (WBS)