Ian Alfredo Magno PURSUANT to Sections 170 and 171 of RA 7875, otherwise known as the National Health Insurance Act of 2013 as amended by RA 10606, individuals may be held liable for unscrupulous acts, to wit: “SECTION 170.Fraudulent Acts. Any member who, for purposes of claiming PhilHealth benefits or entitlement thereto, shall commit any of the offenses provided for in Sections 154 to 163 and Sections 166 and 168 hereof, independently or in connivance with the health care provider. SECTION 171.Criminal Liability. In addition, a criminal complaint shall be filed against the member before the Office of the Prosecutor for the above violations which carry a penalty of imprisonment of not less than six (6) months but not more than one (1) year.” Meanwhile, Sections 154 to 163 and 166 to 168 speak about offenses which may be committed by Health Care Institutions (HCIs) and Health Care Professionals (HCPs), which may be padding of claims, claims for non-admitted or non-treated patients, extending period of confinement, post-dating of claims, misrepresentation by furnishing false or incorrect information, filing of multiple claims, unjustified admission beyond accredited bed capacity, unauthorized operations beyond service capacity, fabrication or possession of fabricated forms and supporting documents and other fraudulent acts; misrepresentation by false or incorrect information by HCPs, breach of warranties of accreditation /performance commitment and other violations such as those which tend to undermine or defeat the objectives of the Program. Among such violations that “undermine or defeat the objectives of the Program” is the apparent counterfeiting of Member Data Records (MDRs).  This MDR is a piece of document issued by PhilHealth to serve as proof of membership principally for purposes of availment of benefits by the member. One very important feature of the MDR – a public document for evidentiary purposes – is the Philhealth Identification Number (PIN) of the member.  Such PIN, once assigned to one person, is exclusively his alone for all time.  Thus, it could not be transferred, re-assigned nor borrowed by another for any purpose whatsoever.  It is further stressed that only PhilHealth could generate and assign such PIN without any participation nor suggestions of preference by any member or anybody at all.  Therefore, any counterfeited MDR with a counterfeit PIN, to that effect, is easily detected and perceived. So, what is the point faking it?  Really, none except that the perpetrator would be exposed to prosecution and pursued by the long arm of the law. The Member Data Record can be obtained via our Local Health Insurance Office.  Likewise, our satellite offices such as the Philhealth Service Desks and Philhealth Express are stationed in certain areas, where requests for MDR may also be catered.  In addition, we have recent launched an online facility where our members could obtain their MDRs online via www.philhealth.gov.ph. Indeed, there is no need to fabricate or “manufacture” fake MDRs, since this is now readily available.  In this line, therefore, we strongly discourage any and all acts which are in any way related to the proliferation of such fake MDRs or other PhilHealth documents.  Item (b) Section 29 Penal Provisions of RA 10606 states that: “Any member who commits any violation of this Act independently or in connivance with the health care provider for purposes of wrongfully claiming NHIP benefits or entitlement shall be punished with a fine of not less than Five thousand pesos (P5,000.00) or suspension from availment of NHIP benefits for not less than three (3) months but not more than six (6) months, or both, at the discretion of the Corporation.”   (Lawyer Ian Alfredo T. Magno is an associate at Atty. Francis U. Ku & Associates, and deputy legal officer at Philhealth. E-mail: ianalfredom@gmail.com)