August 30, 2025 | 12:00am
MANILA, Philippines — The Philippine Well being Insurance coverage Corp. (PhilHealth) has shaped a workforce that can examine teams or personalities utilizing its Assured and Accessible Drugs for Outpatient Remedy (GAMOT) program in fraudulent actions.
Rey Baleña, appearing vice chairman for company affairs group, stated the Particular Anti-Fraud Unit is tasked to watch and make individuals utilizing GAMOT of their unlawful transactions liable.
“Our president and CEO Dr. Edwin Mercado has established a particular unit that can act on pressing fraud issues in relation to GAMOT and different of PhilHealth’s advantages package deal,” Baleña stated.
He added: “Apart from defending the members’ funds, it’ll concentrate on the investigation of various unlawful acts utilizing the company’s applications – such because the Yakap (Yakap sa Kalusugan) program, whereby GAMOT is a part of, and file acceptable circumstances in court docket.”
Beginning with how a member is assigned or registered to their Yakap clinic of alternative, he stated they make it possible for the individual exists or is alive.
“The registration is made by the egov PH app which is handy and is linked with the Nationwide ID system,” he stated.
Baleña added they will even implement strict verification of those that would register on the level of providers.
“We’ll combine that within the system, in order that nobody will be capable to cheat or abuse this system,” he stated.
Baleña appealed to members to instantly report any info on fraudulent actions focusing on PhilHealth’s applications.
Underneath the GAMOT program, PhilHealth members can avail themselves of 75 varieties of medication value P20,000 per yr.
There at the moment are eight accredited GAMOT amenities positioned in Metro Manila.
Aside from the eight accredited GAMOT amenities positioned in Metro Manila, there are 24 pharmacies and drug shops presently making use of for accreditation beneath this system.
