TUGUEGARAO CITY, Philippines- Cagayan Provincial Health Office (PHO) Officer-in-Charge Doctor Carlos Cortina III said the PhilHealth accreditation of Matilde A. Olivas District Hospital in Camalaniugan is “definitely” at risk because of the alleged “upcasing” of diagnosis by two medical officers.
In Cagayan Provincial Information Office’s (CPIO) Kapehan sa Kapitolyo on Monday, October 2, Doctor Cortina said both Philhealth and the capitol’s legal division are already conducting parallel investigation on the case. He said all charts of the hospital have also been submitted to PhilHealth for inquiry.
If proven true, hospital chief Doctor Belma Barrientos, Doctor Rosette De Leon, and Doctor Jane Berona may face suspension, removal, or cancellation of medical license.
Cortina admitted that the people will largely be affected of the consequences of the alleged anomaly.
He also said Matilde district hospital generates around P8 million to P10 million a year, giving a huge revenue for the province.
‘Altering’ of tests
The issue stemmed from irregularities in charts of patients in the said district hospital in the course of PhilHealth’s regional monitoring.
Cortina said the health insurance agency found out that the identified doctors “allegedly altered laboratory tests to suit their diagnosis, to be able to collect a bigger sum of money from PhilHealth claims.”
Cortina explained that PhilHealth had earlier requested a clarification of the alleged five questionable charts but had found the hospital’s justification “not meritorious,” prompting a more thorough investigation.
However, in his own investigation, Cortina said the medical officers may have only made completion of requirements and documents, and not upcasing.
“They completed the chart and diagnosis. May lacking documents so they completed [the chart],” Cortina said, adding that there is no problem in such a case.
Cortina, however, said that it is up to the PhilHealth’s investigating team to decide based on their findings.
He also revealed that an anonymous source within the organization sent a message to Governor Manuel Mamba through Messenger, alleging the accused doctors of the said act.
Mamba had since ordered the preventive suspension of the said doctors for 45 days, starting September 25 to November 9. Northernforum.net