Streamlined, transparent, and consistent – the very values by which corporate procedures should be anchored upon. The same values prove indispensable for the Philippine Health Insurance Corporation (PhilHealth) in its pursuit of Universal Health Care (UHC).
Two (2) batches of the PhilHealth Internal Audit Summit 2018 were held on October 9-10, 2018 in Davao City and on October 17-18 in Pasig City to create opportunities for the Corporation to be oriented on the concepts of: 1) governance through integrity development and strategy management; 2) risk management; and 3) internal controls. These areas are in relation to Internal Audit Group’s functions to evaluate and improve the effectiveness of governance, risk management and control processes. Resource speakers from the Office of the President, Department of Justice, Commission on Audit, and PhilHealth gave talks on these three processes. The Summit also paved the way for discussions on major audit observations and recommendations for related operational issues and activities that address such gaps. PhilHealth Regional Offices in CAR, I, II, III, National Capital Region, IV-A, IV-B, V, VI, VII, VIII, IX, X, XI, XII, Caraga and ARMM were represented by their respective officials and employees to provide inputs on best practices and operational concerns.
Dr. Clementine Bautista, Vice President for the Internal Audit Group (IAG), reiterated the concepts of good governance and stressed the importance of internal management and controls in her welcome remarks. She added that, “This summit also aims to discuss the results of our recently concluded audits with the end in view of improving PhilHealth’s internal control system.”
For his part, Dr. Roy B. Ferrer, Acting President and CEO of PhilHealth, said that, “As the implementer of the NHIP, it is imperative that we run a tight ship if we are to ensure our beneficiaries’ access to quality and affordable health care. Our service delivery cannot afford to be hampered by operational gaps and inconsistent policies. Hence, it is of great benefit to have iron-clad auditing beliefs that are not tarnished by misdirection, bias, and irregularities.” He further stated that effective risk management is crucial in forecasting potential risks and its impact to the Corporation. “There will be instances wherein risks are inevitable but through our activity, we would be able to thresh out acceptable risks from those which necessitate impeccable planning to lessen its impact.”
The first resource person to take the stage was Atty. Froilan D. Montalban, Jr., currently assigned in the Discipline Office under the Office of the President of the Philippines. He discussed integrity development with the participants and highlighted its relevance to good governance. “Basically, governance is about the process of how you exercise your authority,” Montalban lectured. “Governance should be exercised with integrity.”
On the other hand, Ryan C. Thomas, Officer-in-Charge Director of the Planning and Management Services of the Department of Justice, lent his expertise in strategy management. He emphasized the significance of sound and definitive strategies in attaining corporate goals as well as needed resources to support staffing efforts. These resources include infrastructures, supplies, and logistics, to name a few.
Moreover, Thomas observed that the Corporation should exercise careful deliberation in setting target objectives in order to arrive at reasonable and realistic goals that can be achieved within the capacity of existing workforce and assets. The comment was received favorably since the participants were directly involved in day-to-day operations and recognize the needed augmentations to meet the demands of the NHIP – the membership base of which now stands at over 100 million.
The event also featured PhilHealth officers who provided inputs to the discussions with their respective topics. Senior Manager of the Project Management Team for Risk Management Ann Marie C. San Andres provided a detailed presentation on risk management and pointed out activities that could potentially pose risks to the Corporation.
Atty. Jay R. Villegas, Vice President for Arbitration, stepped in for the Commission on Audit (CoA) in Pasig City and talked about the internal control standards for the Philippine Public Sector. Internal controls are important according to Villegas because “...they align the objectives of the [government] agency. It must be connected to the institution’s goals,” adding that, “Accountability must be clearly defined in every steps, policy, or programs that we issue or implement as internal controls.” In Davao City, Humphry Torres stressed the importance of internal controls as they protect weak people from temptation; strong people from opportunity; and innocent people from suspicion. He, however, advised that “there is no one-size fits all” internal controls.
The PhilHealth Internal Audit Manual was presented by Dr. Bautista who was the last to face the audience. She focused on the auditing methods of the Corporation as aligned with prevailing international standards of professional practice. Her presentation helped the participants in understanding the processes of internal auditing and the innovations needed to sustain it as a critical function that will benefit the Corporation.
Audit observations and recommendations dominated the second day of the activity with IAG Auditing Systems Specialists Ariel Enriquez, Alfredo Danieles Jr., and Necoroma Pajares presenting audit findings on unwarranted claims, medical post-audits, and procurement of laptops, respectively. The participants raised queries, concerns and possible solutions to address the audit observations.
At the end of the day, suggested solutions such as outsourcing, risk management, revisiting the policy/guidelines, process improvement, fast tracking reorganization, systems integration, to name a few, were determined as actions that need to be looked upon by the Board (through the Audit Committee) and Management to address the audit observations.
In conclusion, the IAG assured the participants of a swift response to their needs and made sure their concerns will be discussed to the Audit Committee for appropriate resolutions. END (JJ Rico)