Title
Philippine Health Insurance Corp. vs. Commission on Audit
Case
G.R. No. 250089
Decision Date
Nov 9, 2021
PHIC's disallowed employee benefits, totaling PHP 56.5M, lacked presidential approval under P.D. 1597. SC upheld COA's disallowance, ruling PHIC's fiscal autonomy not absolute; refunds ordered, except for good-faith certifying officers.

Case Summary (G.R. No. 250089)

Background of the Case

PhilHealth, created under R.A. No. 7875, is a government-owned and controlled corporation responsible for administering the national health insurance program in the Philippines. The COA determined that PhilHealth disbursed significant allowances and benefits to its officials and employees in 2012 totaling P56,577,286.88, which were subsequently disallowed due to lack of legal basis and absence of necessary approvals.

COA Findings

The COA, upon conducting a routine audit, issued ND No. 2013-01(12), disallowing numerous benefits provided by PhilHealth, including Shuttle Service Allowance, Medical Mission and Critical Allowance, Birthday Gift, and others, due to non-compliance with statutory provisions requiring prior approval from the President for such allowances. The COA clarified that even if fiscal autonomy was granted, it did not grant absolute discretion to approve compensation independently.

Petitioner’s Arguments

PhilHealth appealed the ND, contending that its fiscal autonomy allowed it to determine compensation and allocation of benefits independently. PhilHealth cited executive communications from former President Gloria Macapagal-Arroyo recognizing this autonomy and argued that the benefits were granted in good faith based on board resolutions previously accepted.

COA's Ruling on the Appeal

The COA rejected PhilHealth's appeal, affirming its ND, asserting that the issuance of benefits still required presidential approval as enforced by P.D. No. 1597. The COA emphasized that their audit authority was fundamental in ensuring appropriate use of public funds and concluded that the lack of required approvals rendered the allowances illegal and subject to disallowance.

Legal Analysis

The Supreme Court upheld the findings of the COA, asserting that the nature of PhilHealth as a GOCC necessitates conformance with national guidelines on compensation, including adherence to P.D. No. 1597 and R.A. No. 6758, which clearly outline the requirements for the issuance of allowances and benefits.

Liability of PhilHealth Officials

The decision highlighted that while recipients of the disallowed allowances would generally be presumed to act in good faith, this could be overridden by sufficient evidence of negligence, malice, or a lack of due diligence. Approving officers were found jointly liable for gross negligence for failing to observe

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