PhilHealth has formed a special Anti-Fraud Unit to investigate the misuse of the GAMOT program or Guaranteed and Accessible Medications for Outpatient Treatment. This aims to hold individuals or groups using the program accountable for illegal transactions.
According to Rey Baleña, acting vice president for corporate affairs, the new unit focuses on protecting member funds and filing cases against those proven to be involved. This includes the Yakap sa Kalusugan program of which GAMOT is a part.
To ensure that members are real and alive, registration at Yakap clinics is conducted using the eGov PH app connected to the National ID system. There is also a stricter verification process at the point of service to prevent fraud.
Baleña called on all members to immediately report any fraudulent activities against PhilHealth programs. Under the GAMOT program, members can get up to ₱20,000 worth of 75 types of drugs per year.
Currently, there are 8 accredited GAMOT facilities in Metro Manila and 24 pharmacies and drug stores currently applying to be accredited in the program.
