Request For Issuance of Subpoena Duces Tecum: Complainant

REPUBLIC OF THE PHILIPPINES
PHILIPPINE HEALTH INSURANCE CORPORATION

ARBITRATION OFFICE
Citystate Centre, 709 Shaw Boulevard, Pasig City
PHILIPPINE HEALTH
INSURANCE CORPORATION,
Complainant,
PHIC CASE NO. HCP-NCR-19-0105
PROSEC REF. NO. 092316-329
FOR: M i s rep r e s e n t a t i o n
by Furnishing False or
-versus- Incorrect Information
(Sec. 154) and Breach of
Warranties/Performance
Commitment (Sec. 160)
of the IRR of R.A. 7875,
PACIFIC EYE INSTITUTE, as amended by R.A. 9241
Respondent. and R.A. 10606
x----------------------------------x
REQUEST FOR ISSUANCE OF

SUBPOENA DUCES TECUM
RESPONDENT PACIFIC EYE INSTITUTE (“PEI”), through
counsel and by way of special appearance ex abundanti ad cautelam
without submitting to the jurisdiction of this HONORABLE OFFICE,
respectfully states:
That on 08 July 2019, R ESPONDENT received an Order, dated 11

June 2019, for it to submit its Position Paper within fifteen (15) days;
That, however, said Order did not address RESPONDENT’s motion

for the issuance of subpoena duces tecum which had been included in
the Prayer of its Verified Answer Ex Abundanti Cautelam, dated and
filed on 29 May 2019, for the production of four (4) supporting
documents which should have been attached to the Complaint/
Formal Charge, to wit:
1. the Fact Finding Investigation Report (“FFIR”) of

the Fact-Finding Investigation and Enforcement Division
(“FFIED”) of COMPLAINANT PHIC,
PHIC v. Pacific Eye Institute Request for Subpoena Duces Tecum
PHIC Case No. HCP-NCR-19-0105 page 2 of 3
==============
2. the PROSEC Resolution finding probable cause to file

the Formal Charge,
3. the pre-cataract surgery authorization form of

PhilHealth Member, Mr. Danilo C. Bulandus, and
4. the Notice of Payment to PEI for claim

reimbursement.
That RESPONDENT had earlier pointed out1 that the NHIA and its
IRR both empower COMPLAINANT PHIC to issue subpoenae duces
tecum to its own FFIED and PROSEC in order to make them produce
these four (4) documents for the clarification of this HONORABLE OFFICE
regarding this case;2
That the four (4) said documents are sought to be produced for
the following specific purposes:
1. The FFIR will show that the FFIED used the private Code
of Ethics of the Philippine Academy of Ophthalmologists (“PAO”) as
basis in finding RESPONDENT PEI had supposedly engaged in patient
solicitation and recruitment schemes.3 Moreover, the FFIR will show
that PEI had actually rendered health care services to its patients,
more specifically to Mr. Bulandus, which services it had provided
after giving the requisite PhilHealth discount upon the COMPLAINANT
PHIC’s guarantee for reimbursement.4
2. The Resolution will show that the PROSEC had no

probable cause to charge RESPONDENT PEI with having committed
Misrepresentation or Breaches of Warranties of Accreditation; t his
despite the PROSEC citing without attribution in its Formal Charge
1
Motion for Extension of Time to File Verified Answer, dated 14 May
2019.
See REP. ACT NO. 7875, as amended by REP. ACT NO. 9241 and REP. ACT NO.
2
10606 (“NHIA”), sec. 17(b); and IRR of NHIA, sec. 75(b).

3
PhilHealth Circular No. 19 s.2007, items 2.1, 2.2, 2.3, 2.4, and 2.5
IRR of NHIA, sec. 3(mm) (“All services provided shall receive

4
reimbursement from PhilHealth.”) and sec. 54 (which expressly mandates that

accredited health care providers who participate in the National Health
Insurance Program “shall receive reimbursement from PhilHealth for services
provided” in return for their commitment to provide quality health care services
to PhilHealth members and their dependents.)
PHIC v. Pacific Eye Institute Request for Subpoena Duces Tecum
PHIC Case No. HCP-NCR-19-0105 page 3 of 3
==============
that it had somehow “established” that, “recruitment of possible

cataract patients was conducted in designated areas and
after finding prospective patient, free cataract operation
was conducted at PEI through Dr. Barasi, where the
concerned LGU personnel assisted the patient and even
provided for free use of vehicle” (boldfaced text in the original).5
3. The Pre-Cataract Surgery Authorization Form will show

that COMPLAINANT PHIC had knowingly permitted RESPONDENT PEI to
have its surgeons operate on Mr. Bulandus with the express authority
of PHIC.
4. The Notice of Payment, if at all produced by COMPLAINANT

PHIC, will be evidence that RESPONDENT PEI had indeed been paid
reimbursement for the PhilHealth discount PEI had given to Mr.
Bulandus for his cataract surgery; if, however, no Notice is produced,
then it is proof of absence of “unnecessary financial gain” on the part
of PEI as regards Mr. Bulandus’s surgery,6 and of fraud on the part of
PHIC as discussed in the Verified Answer.7
WHEREFORE, RESPONDENT PEI respectfully reiterates its

Motion for Subpoena for the production of the four (4) aforestated
documents, which subpoena this HONORABLE OFFICE can issue in the
exercise of its quasi-judicial power under Section 103(g) of the IRR of
the NHIA.
RESPECTFULLY SUBMITTED.
Pasig City, 16 July 2019.
MARLON ANTHONY R. TONSON

PTR No. A-4320012/01.22.2019/Taguig City
IBP No. 1068191, January 10, 2019
MCLE COMPLIANCE No. VI-0027744
ROLL O
F ATTORNEYS No. 48574
5
PROSEC Formal Charge, dated 28 February 2019, but filed with the
Arbitration Office Docket on 04 March 2019 and verified only on 10 April 2019,
at paragraph X, on page 4.
6
Verified Answer Ex Abundanti Cautelam, dated 29 May 2019, under the
heading “C.3. No Unethical or Improper Practice”, paragraphs 107-108, on pages
28-29.
7
Id., under the heading “B.5. Lack of Jurisdiction for Engaging in Fraud”,
paragraphs 267-296, on pages 69-76.

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REPUBLIC OF THE PHILIPPINES

PHILIPPINE HEALTH INSURANCE CORPORATION