Manila
EN BANC
[ G.R. No. 222710. July 24, 2018 ]
PHILIPPINE HEALTH INSURANCE CORPORATION, PETITIONER, VS. COMMISSION ON AUDIT, CHAIRPERSON MICHAEL G. AGUINALDO, DIRECTOR JOSEPH B. ANACAY AND SUPERVISING AUDITOR ELENA L. AGUSTIN, RESPONDENTS.
DECISION
TIJAM, J.:
Before Us is a special civil action for certiorari1 with prayer for Temporary Restraining Order (TRO) and Writ of Preliminary Injunction (WPI) under Rule 64, in relation to Rule 65 of the Rules of Court, filed by the petitioner, Philippine Health Insurance Corporation (PhilHealth), which seeks to annul and set aside the Decision No. 2015-0942 dated April 1, 2015 and Resolution3 dated November 9, 2015 of the respondent Commission on Audit (COA). The said Decision and Resolution affirmed the Notice of Disallowance (ND) No. H.O. 12-005 (11)4 dated July 23, 2012 on the payment of longevity pay to its officers and employees for the period of January to September 2011 in the amount of PhP5,575,294.70 under Republic Act (RA) No. 7305 or otherwise known as The Magna Carta of Public Health Workers.
Antecedent Facts
On March 26, 1992, RA No. 7305, otherwise known as The Magna Carta of Public Health Workers was signed into law in order to: promote and improve the social and economic well-being of the health workers, their living and working conditions and terms of employment; develop their skills and capabilities in order that they will be more responsive and better equipped to deliver health projects and programs; and, encourage those with proper qualifications and excellent abilities to join and remain in government service.5 Accordingly, public health workers (PHWs) were granted allowances and benefits, among others, the longevity pay, which states:
Section 23. Longevity Pay. - A monthly longevity pay equivalent to five percent (5%) of the monthly basic pay shall be paid to a health worker for every five (5) years of continuous, efficient and meritorious services rendered as certified by the chief of office concerned, commencing with the service after the approval of this Act.6 (Emphasis ours)
Pursuant to RA No. 7305, which mandates the payment of longevity pay to public health workers, former Department of Health (DOH) Secretary Alberto G. Romualdez, Jr. issued a Certification dated February 20, 2000, declaring PhilHealth officers and employees as public health workers.7
For another, the Office of the Government Corporate Counsel (OGCC) in its Opinion 064, Series of 2001, dated April 26, 20018, stated that the term health-related work under Section 39 of RA No. 7305, includes not only the direct delivery or provision of health services but also the aspect of financing and regulation of health services. Thus, in its opinion, the PhilHealth officers and employees were deemed engaged in health-related works for purposes of entitlement to the longevity pay.10
On August 1, 2011, former PhilHealth President and CEO Dr. Rey B. Aquino issued Office Order No. 0053, S-2011, prescribing the guidelines on the grant of longevity pay, incorporating it in the basic salary of qualified PhilHealth employees for the year 2011 and every year thereafter.11
On January 31, 2012, the PhilHealth Board passed and approved Resolution No. 1584, S. 2012, which among others, confirmed the grant of longevity pay to its officers and employees for the period of January to September 2011 in the amount of PhP5,575,294.70.12
However, on post-audit of the Personal Services account for Calendar Year (CY) 2011, COA Supervising Auditor Ms. Elena C. Agustin (Supervising Auditor Agustin), also a respondent in this case, issued Audit Observation Memorandum (AOM) 2012-09 (11) dated April 30, 2012, which found lack of legal basis for the grant of longevity pay, thus recommended the discontinuance of the grant thereof.13
On May 18, 2012, PhilHealth, through its then President and CEO Dr. Eduardo P. Banzon (Dr. Banzon) asserted that PhilHealth personnel were public health workers, as determined by the DOH in its February 20, 2000 Certification and opined by the OGCC in its Opinion 064, Series of 2001 dated April 26, 2001 and therefore entitled to the grant of longevity pay under RA No. 7305.14
However, Supervising Auditor Agustin found unsatisfactory the justifications for the grant of longevity pay, and thus issued ND No. H.O. 12-005 (11) dated July 23, 2012.15
Philhealth received the ND No. H.O. 12-005 (11) on July 30, 2012, and after 179 days from receipt thereof or on January 25, 2013, Philhealth filed its appeal memorandum before the COA Corporate Government Sector.
The COA Corporate Government Sector upheld the ND No. H.O. 12-005 (11) in its Decision16 No. 2014-002 dated March 13, 2014. The COA ruled that PhilHealth personnel were not public health workers but merely engaged in paying and utilization of health services by its covered beneficiaries. The dispositive portion of the Decision No. 2014-002, provides:
WHEREFORE, premises considered, the instant Appeal is DENIED. Accordingly, ND No. H.O. 12-005 (11) dated July 23, 2012 is hereby affirmed.17
PhilHealth received the above decision on March 25, 2014. PhilHealth filed a motion for extension of time of thirty (30) days, from March 30, 2014 to April 30, 2014, to file the petition for review.18 Thereafter, on April 30, 2014, PhilHealth filed its petition for review before the COA Commission Proper (CP).19
On April 1, 2015, the COA CP in a Decision No. 2015-094,20 dismissed the petition for being filed out of time.ℒαwρhi৷ It ruled that under Section 4821 of Presidential Decree (PD) No. 1445, and Rule VII, Section 3 of the 2009 Revised Rules of Procedure of COA22, the reglementary period to appeal the decision of an auditor is six (6) months or 180 days from receipt of the Decision. The COA found that PhilHealth filed its motion for extension of time to file the petition for review only after the lapsed of the said period. The fallo of the COA Decision No. 2015-094, provides:
WHEREFORE, premises considered, the instant petition for review is hereby DISMISSED for having been filed out of time. Accordingly, Commission on Audit Corporate Government Sector-6 Decision No. 2014-002 dated March 13, 2014, affirming Notice of Disallowance No. H.O. 12-005 (11) dated July 23, 2012, on the payment of longevity pay under the Magna Carta for Public Health Workers to the officers and employees of Philippine Health Insurance Corporation for the period January to September 2011 in the total amount of P5,575,294.70, is final and executory.23
PhilHealth's motion for reconsideration24 was likewise denied in the November 9, 2015 Resolution25. It ruled that PhilHealth failed to show any valid reason to justify the delayed filing, and affirmed the ND No. H.O. 12-005 (11) dated July 23, 2012.
Aggrieved, PhilHealth filed the instant Petition for Certiorari with prayer for TRO and WPI before the Court raising the following issues:
COA gravely abused its discretion amounting to lack or excess of jurisdiction in failing to consider Philhealth's appeal and dismissing outright the same for being filed out of time despite the following arguments offered by Philhealth:
A. THE TERM "MONTH" IN THE SIX-MONTH REGLEMENTARY PERIOD TO FILE AN APPEAL, PURSUANT TO THE 2009 REVISED RULES OF PROCEDURE OF COA, SHOULD BE UNDERSTOOD TO MEAN THE 30-DAY MONTH.
B. PHILHEALTH PERSONNEL ARE "PUBLIC HEALTH WORKERS" WITHIN THE CONTEMPLATION OF SECTION 3 OF RA 7305 AS WELL AS SECTION 1 OF RULE III OF ITS RIRR.
C. PHILHEALTH PERSONNEL ARE NOT ENGAGED MERELY IN "PAYING" FOR THE UTILIZATION OF HEALTH SERVICES BY COVERED BENEFICIARIES, BUT ARE ENGAGED IN HEALTH AND HEALTH-RELATED WORK, AS CLEARLY SPELLED OUT IN THE PROVISIONS OF RA 7875, AS AMENDED.
D. PURSUANT TO HIS AUTHORITY UNDER RA 7305, FORMER HEALTH SECRETARY ALBERTO G. ROMUALDEZ, JR., CERTIFIED THAT PHILHEALTH OFFICIALS AND EMPLOYEES ARE PERFORMING HEALTH AND HEALTH-RELATED FUNCTIONS, AND, AS SUCH, ARE COVERED BY THE PROVISIONS OF THIS LAW.
E. UNTIL SET ASIDE BY THE COURT, THE RIRR OF RA 7305 IS ENTITLED TO THE PRESUMPTION OF LEGALITY. THIS IS A NECESSARY CONSEQUENCE OF THE WELL-ESTABLISHED PRACTICE OF ACCORDING THE FORCE AND EFFECT OF A LAW TO RULES AND REGULATIONS ISSUED BY THE AGENCY TASKED TO ENFORCE OR IMPLEMENT A LAW.
F. SECTION 1 (B) OF RULE III OF THE RIRR OF RA 7305 HAS NOT BEEN PREVIOUSLY INTERPRETED BY THE COURT, AND, THUS, THE UNIFORM CONSTRUCTION PLACED THEREON BY THE DOH MUST BE ACCORDED WEIGHT AND CONSIDERATION.
G. THE PHILHEALTH BOARD UNANIMOUSLY CONFIRMED THE GRANT OF PUBLIC HEALTH WORKERS' BENEFITS, INCLUDING THE LONGEVITY PAY, TO PHILHEALTH OFFICIALS AND EMPLOYEES, UNDER ITS RESOLUTION 1584, S. 2012 OF 31 JANUARY 2012.
H. ARTICLE IV, SECTION 16 (N) OF RA 7875, AS AMENDED, EXPLICITLY BESTOWED PHILHEALTH WITH "FISCAL AUTONOMY" TO FIX THE COMPENSATION OF ITS PERSONNEL.
I. THE FISCAL AUTHORITY OF PHILHEALTH UNDER ARTICLE IV, SECTION 16 (N) OF RA 7875, AS AMENDED, HAD BEEN CONFIRMED TWICE BY FORMER PRESIDENT GLORIA M. ARROYO.
J. THE GRANT OF THE SUBJECT LONGEVITY PAY TO PHILHEALTH PERSONNEL MAY BE CONSIDERED A MINISTERIAL DUTY OR FUNCTION OF THE PHILHEALTH BOARD.
K. RA 7875, AS AMENDED, AND RA 7305 PREVAIL OVER RA 10147, THE FIRST TWO LAWS BEING SPECIAL LAWS, WHILE THE LATTER IS A GENERAL LAW.
L. PHILHEALTH OFFICIALS AND EMPLOYEES RECEIVED THE SUBJECT LONGEVITY PAY IN GOOD FAITH AND, THEREFORE, EVEN IF THE DISALLOWANCE IS SUSTAINED, THEY CANNOT BE REQUIRED TO REFUND THE DISALLOWED AMOUNT.26
Substantially the issues for Our resolution are as follows:
1. Whether COA gravely abused its discretion amounting to lack or excess of jurisdiction in dismissing outright the PhilHealth's appeal.
2. Whether PhilHealth personnel are considered public health workers within the contemplation of Section 3 of RA No. 7305, as well as Section 1 of Rule III of its Implementing Rules and Regulations (IRR).
3. Whether PhilHealth employees received the longevity pay in good faith and even if the disallowance is sustained, they cannot be required to refund the same.
Our Ruling
The petition fails.
Procedural Aspect -
The COA did not commit grave abuse of discretion
An aggrieved party can assail the Decision of the COA through a petition for certiorari under Rule 64, as ruled in the case of Maritime Industry Authority vs. Commission on Audit:27
A petition under Rule 64 may prosper only after a finding that the administrative agency committed grave abuse of discretion amounting to lack or excess of jurisdiction. Not all errors of the Commission on Audit is reviewable by this court. Thus, a Rule 65 petition is a unique and special rule because it commands limited review of the question raised. As an extraordinary remedy, its purpose is simply to keep the public respondent within the bounds of its jurisdiction or to relieve the petitioner from the public respondent's arbitrary acts. In this review, the Court is confined solely to questions of jurisdiction whenever a tribunal, board or officer exercising judicial or quasi-judicial function acts without jurisdiction or in excess of jurisdiction, or with grave abuse of discretion amounting to lack or excess of jurisdiction.
The limitation of the Court's power of review over COA rulings merely complements its nature as an independent constitutional body that is tasked to safeguard the proper use of the government and, ultimately, the people's property by vesting it with power to (i) determine whether the government entities comply with the law and the rules in disbursing public funds; and (ii) disallow legal disbursements of these funds.28 (Emphasis supplied)
This Court has consistently held that findings of administrative agencies are generally accorded not only respect but also finality, unless found to have been tainted with grave abuse of discretion. The same was aptly discussed in the case of Maritime29 citing City of General Santos v. Commission on Audit30, to wit:
It is the general policy of the Court to sustain the decisions of administrative authorities, especially one which is constitutionally-created not only on the basis of the doctrine of separation of powers but also for their presumed expertise in the laws that they are entrusted to enforce. Findings of administrative agencies are accorded not only respect but also finality when the decision and order are not tainted with unfairness or arbitrariness that would amount to grave abuse of discretion. It is only when the COA has acted without or in excess of jurisdiction, or with grave abuse of discretion amounting to lack or excess of jurisdiction, that this Court entertains a petition questioning its rulings. There is grave abuse of discretion when there is an evasion of a positive duty or a virtual refusal to perform a duty enjoined by law or to act in contemplation of law as when the judgment rendered is not based on law and evidence but on caprice, whim and despotism.
PhilHealth failed to point out the specific acts of COA which may constitute grave abuse of discretion in disallowing the grants of longevity pay.
PhilHealth failed to appeal within the reglementary period
The burden of proving the validity or legality of the grant of allowance or benefit is with the government agency or entity granting the allowance or benefit, or the employee claiming the same. After the Resident Auditor issues a notice of disallowance, the aggrieved party may appeal the disallowance to the Director within six (6) months from receipt of the decision.31
From the decision of the Director, any aggrieved party may appeal the same within the time remaining of the six (6) months period under Section 4 Rule V32, taking into account the suspension of the running thereof under Section 533 of the same Rule in case of appeals from the Director's decision. At this point, the government agency or employee has the chance to prove the validity of the grant of allowance or benefit. If the appeal is denied, a petition for review or a notice of appeal may be filed before the Commission on Audit Commission Proper (CACP) within the time remaining of the six (6) months period.34 Finally, the aggrieved party may file a petition for certiorari before this court to assail the decision of the CACP.35
Based on the records, PhilHealth received the ND No. H.O. 12-005 (11) on July 30, 2012, and after 179 days from receipt thereof or on January 25, 2013, PhilHealth filed its appeal memorandum before the COA Corporate Government Sector. The COA Corporate Government Sector upheld the ND No. H.O. 12-005 (11) and the same was received by PhilHealth on March 25, 2014. Hence, by that time, it only had a period of one (1) day, or until March 26, 2014, to file its petition for review before the CACP.
However, on March 31, 2014, after the lapse of five (5) days from March 26, 2014, PhilHealth filed a motion for extension of time of thirty (30) days, from March 30, 2014 to April 30, 2014 to file its petition for review.36 Thereafter, on April 30, 2014 or after the lapse of 215 days after the Resident Auditor issued the ND, PhilHealth filed its petition before the CACP.
It is clear that PhilHealth filed its petition beyond the reglementary period to file an appeal which is within six (6) months or 180 days after the Resident Auditor issued a ND. Thus, the Decision No. 2014-002 dated March 13, 2014 of COA Corporate Government Sector which upheld the ND No. H.O. 12-005 (11) dated July 23, 2012 became final and executory pursuant to Section 5137 of the Government Auditing Code of the Philippines.38
Based on the foregoing, it is clear that this petition is procedurally dismissible.
Nevertheless, even if We consider PhilHealth's contention based on the substantive issues, the dismissal of the petition remains.
Substantive Aspect -
PhilHealth personnel are not public health workers
The question then arises whether the PhilHealth personnel are performing functions which are health or health-related to include them within the coverage of RA No. 7305 and consider them as health workers.
In the case of Kapisanan Ng Mga Manggagawa Sa Government Service Insurance System (KMG) v. Commission on Audit, Guillermo N. Carague, et al.,39 the Court held that:
Under Section 3 of R.A. No. 7305, the term "health workers" means:
All persons who are engaged in health and health related work, and all persons employed in all hospitals, sanitaria, health infirmaries, health centers, rural health units, barangay health stations, clinics and other health-related establishments owned and operated by the Government or its political subdivisions with original charters and shall include medical, allied health professionals, administrative and support personnel employed regardless of their employment status.
The Implementing Rules further define "public health workers," or persons engaged in health and health-related work, as follows:
1. Public Health Workers (PHWs) - Persons engaged in health and health-related works. These cover employees in any of the following:
a. Any government entity whose primary function according to its legal mandate is the delivery of health services and the operation of hospitals, sanitaria, health infirmaries, health centers, rural health units, barangay health stations, clinics or other institutional forms which similarly perform health delivery functions, like clinical laboratories, treatment and rehabilitation centers, x-ray facilities and other similar activities involving the rendering of health services to the public; and
b. Offices attached to agencies whose primary function according to their legal mandates involves provision, financing or regulation of health services.
Also covered are medical and allied health professionals, as well as administrative and support personnel, regardless of their employment status.40 (Emphasis supplied; citations ommitted)
Significantly, the classes of persons considered as public health workers under RA No. 7305 and the IRR are those persons required to render primarily health or health-related services, viz:41
(1) employees of government agencies primarily engaged in the delivery of health services;
(2) employees of government agencies primarily engaged in the operation of hospitals, sanitaria, health infirmaries, health centers, rural health units, barangay health stations, clinics or other similar institutions;
(3) employees of government agencies primarily engaged in the operation of clinical laboratories, treatment and rehabilitation centers, x-ray facilities and other similar facilities;
(4) employees in offices attached to government agencies principally involved in financing or regulation of health services;
(5) medical professionals, allied health professionals, administrative and support personnel in the aforementioned agencies or offices; and
(6) employees rendering health or health-related work in offices attached to an agency which is not principally engaged in health or health-related services.
Employees in the sixth category are deemed employees of "health-related establishments," that is, facilities or units engaged in the delivery of health services, although the agencies to which such facilities or units are attached are not primarily involved in health or health-related services. Under the Implementing Rules, such health-related establishments include clinics or medical departments of government corporations, medical corps and hospitals of the Armed Forces of the Philippines, and the specific health service section, division, bureau or unit of a government agency. (Citations ommitted)
In this regard, the Implementing Rules defines a "health-related establishment" as a health service facility or unit which performs health service delivery functions within an agency whose legal mandate is not primarily the delivery of health services.42 Health-related establishments include clinics and medical departments of government corporations, medical corps and hospitals of the Armed Forces of the Philippines (AFP), and the specific health service section, division or bureau of a government agency not primarily engaged in health services.43
Based on the aforequoted provisions of RA No. 7305 and the IRR, it readily shows that to be included within the coverage, an employee must be principally tasked to render health or health-related services44, such as in hospitals, sanitaria, health infirmaries, health centers, clinical laboratories and facilities and other similar activities which involved health services to the public; medical professionals, allied health professionals, administrative and support personnel in the aforementioned agencies or offices; employees of the health-related establishments, that is, facilities or units engaged in the delivery of health services, although the agencies to which such facilities or units are attached are not primarily involved in health or health-related services. Otherwise stated, an employee performing functions not primarily connected with the delivery of health services to the public is not a public health worker within the contemplation of the law.45
Here, PhilHealth's mandate is the administrator of the National Health Insurance Program through which, covered employees may ensure affordable, acceptable, accessible health care services for all citizens of the Philippines. PhilHealth's establishment and purpose was detailed under RA No. 7875 of Article III, Section 5, to wit:
SEC. 5. Estabishment and Purpose - There is hereby created the National Health insurance Program which shall provide health insurance coverage and ensure affordable, acceptable, available and accessible health care services for all citizens of the Philippines, in accordance with the policies and specific provisions of this Act. This social insurance program shall serve as the means for the healthy to help pay for the care of the sick and for those who can afford medical care to subsidize those who cannot. It shall initially consist of Programs I and II or Medicare and be expanded progressively to constitute one universal health insurance program for the entire population. The Program shall include a sustainable system of funds constitution, collection, management and disbursement for financing the availment of a basic minimum package and other supplementary packages of health insurance benefits by a progressively expanding proportion of the population. The Program shall be limited to paying for the utilization of health services by covered beneficiaries or to purchasing health services in behalf of such beneficiaries. It shall be prohibited from providing health care directly, from buying and dispensing drugs and pharmaceuticals, from employing physicians and other professionals for the purpose of directly rendering care, and from owning or investing in health care facilities. (Emphasis Ours)
Stated otherwise, PhilHealth is prohibited from providing health care directly, from buying and dispensing drugs and pharmaceuticals, from employing physicians and other professionals for the purpose of directly rendering care, and from owning or investing in health care facilities.46
Clearly, the functions of the PhilHealth personnel are not principally related to health services. Its powers and functions are elaborated under Article IV, Section 16 of RA No. 7875:
SEC. 16. Powers and Functions - The Corporation shall have the following powers and functions:
a) To administer the National Health Insurance Program;
b) To formulate and promulgate policies for the sound administration of the Program;
c) To supervise the provision of health benefits and to set standards, rules, and regulations necessary to ensure quality of care, appropriate utilization of services, fund viability, member satisfaction, and overall accomplishment of Program objectives;
d) To formulate and implement guidelines on contributions and benefits; portability of benefits, cost containment and quality assurance; and health care provider arrangements, payment, methods, and referral systems;
e) To establish branch offices as mandated in Article V of this Act;
f) To receive and manage grants, donations, and other forms of assistance;
g) To sue and be sued in court;
h) To acquire property, real and personal, which may be necessary or expedient for the attainment of the purposes of this Act;
i) To collect, deposit, invest, administer, and disburse the National Health Insurance Fund in accordance with the provisions of this Act;
j) To negotiate and enter into contracts with health care institutions, professionals, and other persons, juridical or natural, regarding the pricing, payment mechanisms, design and implementation of administrative and operating systems and procedures, financing, and delivery of health services in behalf of its members;
k) To authorize Local Health Insurance Offices to negotiate and enter into contracts in the name and on behalf of the Corporation with any accredited government or private sector health provider organization, including but not limited to health maintenance organizations, cooperatives and medical foundations, for the provision of at least the minimum package of personal health services prescribed by the Corporation;
l) To determine requirements and issue guidelines for the accreditation of health care providers for the Program in accordance with this Act;
m) To visit, enter and inspect facilities of health care providers and employers during office hours, unless there is reason to believe that inspection has to be done beyond office hours, and where applicable, secure copies of their medical, financial, and other records and data pertinent to the claims, accreditation, premium contribution, and that of their patients or employees, who are members of the Program;
n) To organize its office, fix the compensation of and appoint personnel as may be deemed necessary and upon the recommendation of the president of the Corporation;
o) To submit to the President of the Philippines and to both Houses of Congress its Annual Report which shall contain the status of the National Health Insurance Fund, its total disbursements, reserves, average costing to beneficiaries, any request for additional appropriation, and other data pertinent to the implementation of the Program and publish a synopsis of such report in two (2) newspapers of general circulation;
p) To keep records of the operations of the Corporation and investments of the National Health Insurance Fund;
q) To establish and maintain an electronic database of all its members and ensure its security to facilitate efficient and effective services;
(r) To invest in the acceleration of the Corporation's information technology systems;
(s) To conduct an information campaign on the principles of the NHIP to the public and to accredited health care providers. This campaign must include the current benefit packages provided by the Corporation, the mechanisms to avail of the current benefit packages, the list of accredited and disaccredited health care providers, arid the list of offices/branches where members can pay or check the status of paid health premiums;
(t) To conduct post-audit on the quality of services rendered by health care providers;
(u) To establish an office, or where it is not feasible, designate a focal person in every Philippine Consular Office in all countries where there are Filipino citizens. The office or the focal person shall, among others, process, review and pay the claims of the overseas Filipino workers (OFWs);
(v) Notwithstanding the provisions of any law to the contrary, to impose interest and/or surcharges of not exceeding three percent (3%) per month, as may be fixed by the Corporation, in case of any delay in the remittance of contributions which are due within the prescribed period by an employer, whether public or private. Notwithstanding the provisions of any law to the contrary, the Corporation may also compromise, waive or release, in whole or in part, such interest or surcharges imposed upon employers regardless of the amount involved under such valid terms and conditions it may prescribe;
(w) To endeavor to support the use of technology in the delivery of health care services especially in farflung areas such as, but not limited to, telemedicine, electronic health record, and the establishment of a comprehensive health database;
(x) To monitor compliance by the regulatory agencies with the requirements of this Act and to carry out necessary actions to enforce compliance;
(y) To mandate the national agencies and LGUs to require proof of PhilHealth membership before doing business with a private individual or group;
(z) To accredit independent pharmacies and retail drug outlets; and (aa) To perform such other acts as it may deem appropriate for the attainment of the objectives of the Corporation and for the proper enforcement of the provisions of this Act.47
PhilHealth personnel perform functions which pertain to the effective administration of the National Health Insurance Program or facilitating the availablity of funds of health services to its covered employees, and, among others involve the: determination of requirements and issue guidelines in relation to insurance program; inspection of health care institutions; inspection of medical, financial, and other records relevant to the claims, accreditation, premium contribution of employees covered by the program; and, to keep records of the operations of the Corporation and investments of the National Health Insurance Fund. These functions are not similar to those of persons rendering health or health-related services, or those employees working in health-related establishments, as discussed above. Undoubtedly, the PhilHealth personnel cannot be considered public health workers under RA No. 7305.48
It is Our firm view that PhilHealth functions are not commensurate to the services rendered by those workers who actually and directly provide health care services. PhilHealth's objective as the National Health Insurance Program provider, is to help the people pay for health care services49; unlike workers or employees of the government and private hospitals, clinics, health centers and units, medical service institutions, clinical laboratories, treatment and rehabilitation centers, health-related establishments of government corporations, and the specific health service section, division, bureau or unit of a government agency, who are actually engaged in health work services.
It will also be absurd if the same benefits and treatment will be given to the PhilHealth personnel and to those employees who actually rendered health services. Health workers or employees are not similarly situated with the PhilHealth employees. Health workers have sets of skills, training, medical background, work quality and ethical considerations to patients, and risks in transmission, occupational and hazard exposures, diseases etc., in the performance of their functions, while in PhilHealth, as National Health Insurance Program provider, its policy is only to help the people subsidize; or pay, or finance for the health care services.
More so, if the policy of the State is to include PhilHealth personnel as health workers, the same treatment should be given to Social Security System (SSS)50, Government Service Insurance System (GSIS)51, the Philippine Charity Sweepstakes Office (PCSO)52, and other institutions or agencies, who provide funds for health care services, health programs, medical assistance, against the hazards of disability, sickness, maternity, old age, death and other contingencies resulting in loss of income or financial burden, or funds for life insurance, retirement, disability and survivorship benefits.
But this Court once interpreted and ruled that the Social Insurance Group (SIG) personnel of the GSIS, who acted as administrator of funds for the pension and retirement of government employees, were obviously not a health or health-related establishment.53
We also said that the SIG personnel who perform tasks for the processing of GSIS members' claims for life insurance, retirement, disability and survivorship benefits are not similar to those persons working in health-related establishments such as clinics or medical departments of government corporations, medical corps and hospitals of the AFP, and the specific health service units of government agencies.54 Hence, they are not public health workers under RA No. 7305.
Thus, We maintain that PhilHealth personnel were not engaged in the delivery of health or health-related services, and therefore, not public health workers. The same conclusion is reached in the case of Kapisanan55, when the principle of ejusdem generis is used to ascertain the meaning of the term "public health worker" under R.A. No. 7305 and its Implementing Rules, viz:
Under the principle of ejusdem generis, where a statute describes things of a particular class or kind accompanied by words of a generic character, the generic word will usually be limited to things of a similar nature with those particularly enumerated, unless there be something in the context of the state which would repel such inference.
Applying the principle of ejusdem generis, the inescapable conclusion is that a mere incidental or slight connection between the employee's work and the delivery of health or health-related services is not sufficient to make a government employee a public health worker within the meaning of R.A. 7305. The employee must be principally engaged in the delivery of health or health-related services to be deemed a public health worker.56
Furthermore, the certification issued by the DOH Secretary Alberto G. Romualdez, which declared PhilHealth officers and employees as public health workers is not authoritative.
Although PhilHealth is an attached agency to the DOH, and the latter principally determines who are entitled to the benefits under RA No. 7305, its authority must be in accordance with the standards set forth in the law and the IRR. Moreover, other government agencies such as the Department of Budget and Management (DBM) and the COA, in the performance of their respective functions, are not precluded from reviewing the DOH's determinations. This Court aptly discussed the same in the case of Kapisanan57 (penned by Justice Tinga), to wit:
There is likewise no merit in the KMGs contention that the COA gravely abused its discretion in disallowing the grant of hazard pay to the SIG personnel because it is the DOH which is mandated by law to make the determination as to who are entitled to the benefits under RA No. 7305.
The DOH is the unit of the executive branch of government tasked to administer all laws, rules and regulations in the field of health. In addition, it is the DOH which is specifically tasked under Section 35 of RA No. 7305 to consult the appropriate government agencies and professional and health workers organizations or unions, and thereafter, to formulate and prepare the implementing rules and regulations of RA No. 7305.
Although it is the DOH which principally determines who are specifically entitled to benefits under RA No. 7305, its authority to make such determination must be in accordance with the definition of terms and standards set in the law and its Implementing Rules. Moreover, there is nothing in the law which precludes review of the DOHs determinations by other government agencies such as the DBM and the COA in the performance of their respective functions. In fact, in accordance with Section 35 of RA 7305, the Secretary of Health collaborated with other government agencies and health workers organizations in drafting the Implementing Rules which lay down, among others, the guidelines and procedure for the grant of hazard pay to public health workers. Also, mindful of the objectives of RA No. 7305, the DBM had earlier requested for a moratorium on the DOHs approval of requests made by agencies for certifications that their personnel are covered by RA No. 7305 due to serious lapses in the issuance of such certifications. (Emphasis supplied)
The DBM is mandated by law to assist the Chief Executive in the preparation, execution and control of the national budget. (Emphasis supplied) It was therefore merely performing its duty to enforce and control the use of government funds when it evaluated the grant of hazard pay to the SIG personnel and discovered that such grant was not justified under RA No. 7305. (Emphasis ours)
The COA, on the other hand, is vested by the Constitution with the power and duty to examine, audit and settle all accounts pertaining to the revenue and receipts of, and expenditures or uses of funds or property owned or held in trust by, or pertaining to government owned and controlled corporations with original charters such as the GSIS, on a post-audit basis.It is mandated to determine whether government entities comply with laws and regulations in disbursing government funds, and to disallow illegal or irregular disbursements of government funds.
Thus, the COA acted pursuant to its duty and within the bounds of its jurisdiction in reviewing the grant of hazard pay to the SIG personnel under RA No. 7305 and subsequently disallowing the same for being violative of the provisions thereof.
Considering all the foregoing and under any reasonable yardstick, no grave abuse of discretion can be ascribed to the COA in disallowing the grant of hazard pay benefits to the SIG personnel. Clearly, under RA No. 7305 the SIG personnel are not public health workers. Clearly also under the same law, they are not entitled to hazard pay in any case.
Furthermore, the KMG cannot invoke the previous determinations by the DOH that the SIG personnel are considered public health workers under RA No. 7305 to justify their entitlement to hazard pay under that law.58 (Emphasis Ours)
Hence, PhilHealth cannot rely on the previous determination of the DOH Secretary that PhilHealth officials and employees are performing health and/or health-related functions, and thus, considered public health workers. The said interpretation or certification is not binding against the COA.
In the case of Metropolitan Waterworks and Sewerage System v. Commission on Audit59, the Court held that:
The COA as a constitutional office is endowed with enough latitude to determine, prevent and disallow irregular, unnecessary, excessive, extravagant, or unconscionable expenditures of government funds. It has the power to ascertain whether public funds were utilized for the purpose for which they had been intended. The 1987 Constitution has expressly made COA the guardian of public funds, vesting it with broad powers over all accounts pertaining to government revenue and expenditures and the uses of public funds and property, including the exclusive authority to define the scope of its audit and examination, establish the techniques and methods for such review, and promulgate accounting and auditing rules and regulations.60
Refund of the amounts received
With regard to the disallowance of salaries, emoluments, benefits, and allowances of government employees, prevailing jurisprudence provides that recipients or payees need not refund these disallowed amounts when they received these in good faith. Government officials and employees who received benefits or allowances, which were disallowed, may keep the amounts received if there is no finding of bad faith and the disbursement was made in good faith. On the other hand, officers who participated in the approval of the disallowed allowances or benefits were required to refund only the amounts received when they were found to be in bad faith or grossly negligent amounting to bad faith.61
In Philippine Economic Zone Authority (PEZA) v. Commission on Audit and Reynaldo A. Villar62, this Court defined good faith relative to the requirement of refund of disallowed benefits or allowances.1âшphi1
In common usage, the term "good faith" is ordinarily used to describe that state of mind denoting "honesty of intention, and freedom from knowledge of circumstances which ought to put the holder upon inquiry; an honest intention to abstain from taking any unconscientious advantage of another, even through technicalities of law, together with absence of all information, notice, or benefit or belief of facts which render transaction unconscientious."63 (Emphasis supplied)
The Court however, finds that the COA failed to show bad faith on the part of the approving officers in disbursing the disallowed longevity pay. Further, the PhilHealth officers and other employees were presumed to have acted in good faith when they allowed and/or received the longevity pay, in the honest belief that there was legal basis for such grant. The PhilHealth personnel in turn accepted the longevity pay benefits believing that they were entitled to such benefit.
Even though We find that the PhilHealth personnel who received the longevity pay acted in good faith under the honest belief that there was legal basis for such payment, the return of the received longevity pay in the ND No. H.O. 12-005 (11) dated July 23, 2012 is in Order. We reiterate that the ND No. H.O. 12-005 (11) dated July 23, 2012 already attained its finality for failure of PhilHealth to file an appeal within the reglementary period, which is six (6) months or 180 days after the Resident Auditor issued the disallowance. We can no longer reverse, much less modify the same without disregarding the doctrine of immutability of judgment.
While We are not insensitive to PhilHealth's suffering in view of the refund of the longevity benefits received by them, We are bound by laws and judicial precedents that must be applied to the present case. We discussed the rule on immutability of judgment in Antonio Navarro v. Metropolitan Bank and Trust Company,64 and said:
No other procedural law principle is indeed more settled than that once a judgment becomes final, it is no longer subject to change, revision, amendment or reversal, except only for correction of clerical errors, or the making of nunc pro tunc entries which cause no prejudice to any party, or where the judgment itself is void. The underlying reason for the rule is two-fold: (1) to avoid delay in the administration of justice and thus make orderly the discharge of judicial business, and (2) to put judicial controversies to an end, at the risk of occasional errors, inasmuch as controversies cannot be allowed to drag on indefinitely and the rights and obligations of every litigant must not hang in suspense for an indefinite period of time. As the Court declared in Yau v. Silverio,
Litigation must end and terminate sometime and somewhere, and it is essential to an effective and efficient administration of justice that, once a judgment has become final, the winning party be, not through a mere subterfuge, deprived of the fruits of the verdict. Courts must therefore guard against any scheme calculated to bring about that result. Constituted as they are to put an end to controversies, courts should frown upon any attempt to prolong them.
Indeed, just as a losing party has the right to file an appeal within the prescribed period, the winning party also has the correlative right to enjoy the finality of the resolution of his case by the execution and satisfaction of the judgment. Any attempt to thwart this rigid rule and deny the prevailing litigant his right to savor the fruit of his victory must immediately be struck down. Thus, in Heirs of Wenceslao Samper v. Reciproco-Noble, we had occasion to emphasize the significance of this rule, to wit:
It is an important fundamental principle in our Judicial system that every litigation must come to an end x x x Access to the courts is guaranteed. But there must be a limit thereto. Once a litigant's rights have been adjudicated in a valid final judgment of a competent court, he should not be granted an unbridled license to come back for another try. The prevailing party should not be harassed by subsequent suits. For, if endless litigations were to be encouraged, then unscrupulous litigants will multiply in number to the detriment of the administration ofjustice.65
WHEREFORE, the instant petltwn is DISMISSED. The Commission on Audit Decision No. 2015-094 dated April 1, 2015 and Resolution dated November 9, 2015, which affirmed the Notice of Disallowance No. H.O. 12-005 (11) dated July 23, 2012, on the payment of longevity pay under the Magna Carta for Public Health Workers to the officers and employees of Philippine Health Insurance Corporation for the period January to September 2011 in the total amount of PhP5,575,294.70, are hereby AFFIRMED in toto.
SO ORDERED.
Carpio, Velasco, Jr., Leonardo-De Castro, Peralta, Bersamin, Martires, Reyes, Jr., and Gesmundo, JJ., concur.
Del Castillo, J., I join the dissent of J. Caguioa.
Perlas-Bernabe, J., I join the dissent of J. Leonen.
Leonen, J., I dissent. See separate opinion.
Jardeleza, J., I join dissent of J. Caguioa.
Caguioa, J., I dissent. See separate opinion.
NOTICE OF JUDGMENT
Sirs/Mesdames:
Please take notice that on July 24, 2018 a Decision, copy attached herewith, was rendered by the Supreme Court in the above-entitled case, the original of which was received by this Office on October 9, 2018 at 1:35 p.m.
Very truly yours,
(Sgd)
EDGAR O. ARICHETA
Clerk of Court
Footnotes
1 Rollo, pp. 3-45.
2 Id. at 55-58.
3 Id. at 129.
4 Id. at 131-132.
5 RA No. 7305, SEC. 2. Declaration of the Policy and Objective. Rollo, p. 6.
6 Id. at 36.
7 Id. at 7.
8 Signed by Amado D. Valdez, Government Corporate Counsel. Id. at 239-242.
9 SEC. 3. Definition. - For purposes of this Act, "health workers" shall mean all persons who are engaged in health and health-related work, and all persons employed in all hospitals, sanitaria, health infirmaries, health centers, rural health units, barangay health stations, clinics and other health-related establishments owned and operated by the Government or its political subdivisions with original charters and shall include medical, allied health professional, administrative and support personnel employed regardless of their employment status.
10 Id. at 241-242.
11 Id. at 7.
12 Id.
13 Id. at 7-8.
14 Id. at 8.
15 Id. at 131-132.
16 Id. at 115-120.
17 Id. at 120.
18 Id. at 121-123.
19 Id. at 9.
20 Id. at 55-58.
21 Section 48. Appeal from decision of auditors.- Any person aggrieved by the decision of an auditor of any government agency in the settlement of an account or claim may within six months from receipt of a copy of the decision appeal in writing to the Commission.
22 Section 3. Period of Appeal. - The appeal shall be taken within the time remaining of the six (6) months period under Section 4, Rule V, taking into account the suspension of the running thereof under Section 5 of the same Rule in case of appeals from the Director's decision, or under Sections 9 and 10 of Rule VI in case of decision of the ASB.
23 Id. at 57-58.
24 Id. at 60-113.
25 Id. at 129.
26 Id. at 9-11.
27 750 Phil. 288 (2015).
28 Id. at 307-308.
29 Maritime v. COA, supra at 308.
30 733 Phil. 687 (2014).
31 P.D. 1445 OF THE STATE AUDIT CODE OF THE PHILIPPINES:
Section 48. Appeal from decision of auditors. Any person aggrieved by the decision of an auditor of any government agency in the settlement of an account or claim may within six months from receipt of a copy of the decision appeal in writing to the Commission.
32 RULE V - Proceedings before the Director
x x x x
Section 4. When Appeal Taken - An Appeal must be filed within six (6) months after receipt of the decision appealed from.
33 Section 5. Interruption of Time to Appeal. - The receipt by the Director of the Appeal Memorandum shall stop the running of the period to appeal which shall resume to run upon receipt by the appellant of the Director's decision.
34 RULE VII - Petition for Review to the Commission Proper
x x x x
Section 3. Period of Appeal. - The appeal shall be taken within the time remaining of the six (6) months period under Section 4, Rule V, taking into account the suspension of the running thereof under Section 5 of the same Rule in case of appeals from the Director's decision, or under Sections 9 and 10 of Rule VI in case of decision of the ASB.
35 RULES OF COURT, Rule 64; Maritime v. COA, supra note 27, id. at 307.
36 Rollo, pp. 121-123.
37 THE STATE AUDIT CODE OF THE PHILIPPINES:
Chapter 3 - Decisions of the Commission.
x x x x
Section 51. Finality of decisions of the Commission or any auditor. A decision of the Commission or of any auditor upon any matter within its or his jurisdiction, if not appealed as herein provided, shall be final and executory.
38 Reyna, et al., v. Commission On Audit, 657 Phil. 209, 221 (2011).
39 480 Phil. 861 (2004).
40 Kapisanan Ng Mga Manggagawa Sa GSIS (KMG), v. COA, supra note 39, id. at 874.
41 Supra, id. at 877-878.
42 Kapisanan Ng Mga Manggagawa Sa GSIS (KMG) v. COA, supra note 39, id. at 876.
43 Id.
44 Id.
45 Id.
46 Section 5, Article III of RA No. 7875.
47 As amended by Section 10, REPUBLIC ACT No. 10606, OTHERWISE KNOWN AS THE "NATIONAL HEALTH INSURANCE ACT OF 2013".
48 Kapisanan Ng Mga Manggagawa Sa GSIS (KMG), v. COA Audit, supra note 39.
49 Article 1, Section 3 (b) of RA No. 7875.
50 It is the policy of the State to establish, develop, promote and perfect a sound and viable tax-exempt social security system suitable to the needs of the people throughout the Philippines which shall promote social justice and provide meaningful protection to members and their beneficiaries against the hazards of disability, sickness, maternity, old age, death and other contingencies resulting in loss of income or financial burden. Toward this end, the State shall endeavor to extend social security protection to workers and their beneficiaries. (See Section 2, RA 8282).
51 The GSIS, as the administrator of the funds for the pension and retirement funds of government employees. See Republic Act No. 8291 (the Revised GSIS Act of 1997).
52 SECTION 1. The Philippine Charity Sweepstakes Office. - The Philippine Charity Sweepstakes Office, hereinafter designated the Office, shall be the principal government agency for raising and providing for funds for health programs, medical assistance and services, and charities of national character, and as such shall have the general powers conferred in section thirteen of Act Numbered One thousand four hundred fifty nine, as amended, and shall have the authority: x x x x (See REPUBLIC ACT NO. 1169 - "AN ACT PROVIDING FOR CHARITY SWEEPSTAKES, HORSE RACES, AND LOTTERIES"
53 Kapisanan Ng Mga Manggagawa Sa GSIS (KMG), v. COA, supra note 39, id. at 876.
54 Supra note 39.
55 Id.
56 Kapisanan Ng Mga Manggagawa Sa GSIS (KMG) v. COA, supra at 875.
57 Id.
58 Id. at 883-885.
59 G.R. No. 195105, November 21, 2017. Citing Sanchez, et al. v. Commission on Audit, 575 Phil. 428, 444-445 (2008).
60 Yap v. Commission on Audit, 633 Phil. 174, 189 (2010)
61 Maritime v. COA, supra note 27.
62 690 Phil. 104 (2012).
63 Id. at 115.
64 612 Phil. 462 (2009).
65 Id. at 471-472.
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