CIVIL and legal actions await individuals that will be found as "fake" persons with disability (PWDs) by the Philippine Health Insurance Corporation (PhilHealth).
Based on PhilHealth Circular No. 2026-0017, "fake" PWDs also stand to face possible administrative sanctions for posing as being eligible to avail of the free PhilHealth coverage.
"The submission or use of falsified, expired, cancelled, or fraudulently obtained identification or registry records for purposes of registration, tagging, premium subsidy, or benefit availment is strictly prohibited and shall result in correction of the affected membership record, recovery of any benefit or subsidy improperly availed, and such other liability as may apply," PhilHealth said.
"A member subsequently found not to be a Person with Disability shall have that registration cancelled, retained in the system for audit purposes rather than physically deleted, without prejudice to appropriate legal action," it added.
The state-run health insurer said only PWDs registered in the national registry of the Department of Health (DOH) shall be provided with a full range of medical benefits of PhilHealth.
It said the the coverage of the PWD under the National Health Insurance Program shall be based on the DOH Philippine Registry of Persons with Disability (PRPWD).
"All persons with disability included in the PWD Registry are automatically covered under the National Health Insurance Program, without regard to gender, age, or ethnicity," said PhilHealth.
"The PWD Registry shall serve as PhilHealth's primary and controlling reference for registering, validating, updating, and tagging the membership records of Persons with Disability," it added.
Under Republic Act 11228, the automatic enrollment of all PWDs in the National Health Insurance Program has been made mandatory.
The circular provides that the premium of a PWD classified as Indirect Contributor without employer-employee relationship shall be fully subsidized by the national government.
On the other hand, those classified as Indirect Contributor with employer-employee relationship will have their premium shared equally between the employer and the national government.
In either cases, it said all PWDs shall be entitled to the full range of PhilHealth benefits.
It said all PhilHealth-accredited health care institutions shall apply the 12 percent VAT exemption to total charges first, then apply the 20 percent PWD discount to the resulting balance, before deducting any other PhilHealth benefit.
The PhilHealth policy on PWD membership comes amid reports that about six million Filipinos are found using fake PWD IDs.
This as National Council on Disability Affairs data shows that there are only 2.8 million PWDs but some 8.5 million have a PWD ID. (Anton Banal/SunStar Philippines)