The Philippine Health Insurance Corporation (PhilHealth) released a formal statement earlier this week confirming the Bacolod Our Lady of Mercy Specialty Hospital officially ceased operations on August 1, following the earlier denial of accreditation by the government healthcare provider.
PhilHealth-Western Visayas initially said the hospital’s application for accreditation as a Level 2 provider was denied due to “fraudulent acts.” In response, Negros Healthcare Management Systems, Inc. (NHMSI), which currently manages the hospital, said the acts in question were conducted by previous management, Tiong Bi, Inc.
In their statement, PhilHealth cites the revised implementing rules and regulations for RA 9241, or the National Health Insurance Act of 1995, indicating “fraudulent acts” as grounds for denying accreditation. In addition, they cited Provision 8 of their Performance Commitment for Health Care Institutions, noting: “Any change in ownership and/or management of our institution shall not operate to exempt the previous and/or present owner and/or manager from liabilities for violations.”
PhilHealth claimed Lady of Mercy Hospital tried to “deceive” the government healthcare provider after a certain Dr. Jeremias Manuel K. Moscardon, Jr. was indicated as medical director on their application for continuing accreditation, with Tiong Bi, Inc. as owner and NHMSI as manager. However, Moscardon was also listed on a similar application for Holy Mother of Mercy Hospital in Kabankalan City, with NHMSI as owner.
The statement also pointed out, “The hospital has been convicted twice for committing fraudulent acts which involve [the] padding of claims, misrepresentation by furnishing false or incorrect information, and breach of warranties of accreditation/performance commitment.”
Last year, a congressional hearing of the House Committee on Good Government and Public Accountability revealed some physicians allegedly collected excessive amounts in PhilHealth claims for unnecessary procedures, with the Our Lady of Mercy Hospital named as one of the involved hospitals.
Reports claimed doctors at the said hospital allegedly recommended patients undergo cataract surgery even if it was not necessary./WDJ