Title
Philippine Health Insurance Corp. vs. Commission on Audit
Case
G.R. No. 235832
Decision Date
Nov 3, 2020
PHIC benefits disallowed due to lack of OP approval; COA affirmed, requiring refunds by officials and recipients, citing procedural lapses and fiscal autonomy limits.

Case Summary (G.R. No. 96126)

Applicable Law

The case primarily pertains to the Philippine Health Insurance Corporation established under Republic Act No. 7875, as amended by subsequent laws. The COA's authority to audit and disallow expenditures is based on the provision outlined in the 1987 Philippine Constitution, specifically Articles IX-A and IX-D. Additionally, regulations stipulating the requirements for granting compensation and benefits are anchored in Memorandum Order No. 20 and Administrative Order No. 103.

Antecedents of the Case

The NDs issued by the COA Resident Auditor against PHIC cited various benefits granted without approval from the Office of the President (OP). The total disallowed amounts were substantial, reflecting claims for gifts and allowances that exceeded legal parameters. PHIC contested these NDs on procedural and substantive grounds and pursued appeals within COA, which ultimately affirmed the disallowances at multiple levels.

Rulings by COA Corporate Government Sector

The COA Corporate Government Sector (COA-CGS) ruled against PHIC, denying the appeals related to the NDs and affirming a total disallowance amounting to approximately P204 million. Following this, PHIC sought a petition for review with COA Proper but was met with the same outcomes regarding late filings and non-adherence to procedural requirements.

Disallowance Findings by COA Proper

In its Decision No. 2016-436, the COA Proper dismissed the petition for review on the basis of late filing. It underscored the jurisdictional nature of timely filing appeals. The decision stressed that PHIC’s reliance on fiscal autonomy was misplaced, given that allowances must still conform to legislation such as the Salary Standardization Law (SSL) that integrates benefits into the standardized salary rates of government employees.

Claims of Fiscal Autonomy and Good Faith

PHIC contended that its charter provided fiscal autonomy allowing it to fix compensation for its employees, arguing that all benefits were duly authorized. However, the respondents countered that even if PHIC has such autonomy, it must operate within the confines of applicable laws and COA standards. They argued against the good faith of the PHIC officials, emphasizing a history of prior disallowances that should have informed their actions.

Court's Review and Assessment

The Court's assessment centered on whether the COA Proper committed grave abuse of discretion in dismissing the appeal. It concluded that procedural adherence was critical in administrative proceedings and that PHIC's appeal was indeed late. The Court maintained that PHIC could not presume an extension of time merely based on the filing of a prior motion without formal approval.

Principle of Solutio Indebiti

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