Data errors seen in 1.3M seniors in PhilHealth list while 4,000 dead still on active list – COA

MANILA, Philippines – The Commission on Audit (COA) discovered that around 1.3 million senior citizens in the database of government insurer PhilHealth have data errors, including over 250,000 that were listed twice and 4,000 who have died but remained on the list as of the end of 2023. 

The double or multiple entries equate to at least P1.333 billion in government subsidy that had to be paid to PhilHealth because senior citizens are exempted from paying contributions. 

The 1,335,274 senior citizens who are beneficiaries, and were found to have incomplete or erroneous data at risk of being duplicated in the database, will therefore increase the government subsidies that are erroneous as well. 

The COA audit team verified with 250 hospitals and clinics the information that thousands of dead beneficiaries who died from 2019 to 2022 are still on the database and are still billed to the Department of Budget and Management in 2023.  

As is the case with duplicate entries, dead beneficiaries that aren’t removed from the system mean that the government provides more subsidies to PhilHealth with no real beneficiaries. 

The 1.33 million seniors with data errors represent 15% of the total senior beneficiaries of PhilHealth totaling 8.586 million. About P6.44 billion of the total P42.93 billion in subsidies in 2023 went to those with questionable data entries. 

One common data entry error is that encoders only entered the middle initial instead of the full middle name of the beneficiary in 1,254,136 entries. Some had no middle name indicated at all, and a few had misspellings or no first or last names. 

“The enrollment of members without middle names, with middle initials only, with last names consisting of only one letter, and with other irregularities and errors increases the risk of double or multiple entries per member since the matching validation is programmed to detect only an absolute match,” COA said. 

In 2020, the insurer was already flagged for double or multiple entries in its database. But the audit team found that the flagged problem involving 266,665 entries had still not been addressed, equating to subsidies amounting to P1.3 billion. 

PhilHealth said it is now conducting a clean-up of its database. – Rappler.com