Dr. Madeleine Valera, PhilHealth vice president for health finance policy, said dubious claims include one doctor who billed $367,000 for some 2,000 cataract surgeries in one year.
She said among the cases being investigated by PhilHealth were those involving circumcisions and toenail extractions.
Valera told a Senate hearing, "It would appear [from medical records submitted to PhilHealth] that a lot of Filipinos are 'supot' [uncircumcised] and have infection on their toenails."
"Doctors also have their rackets. More as individuals than as syndicates. Some doctors are in on the scam. Many have earned millions from PhilHealth," Valera said.
She said the scam involved some "scalawag" doctors treating "ghost patients" and making "dubious claims." Others "harvest" these patients by enrolling them in PhilHealth before they are treated.
Valera said that in some cases, hospital-based pharmacies were also involved. She said doctors would prescribe medicines that patients didn't need only to increase hospital bills.
