SC affirms CA ruling vs PhilHealth
By Tetch Torres
INQUIRER.net
First Posted 10:46:00 12/05/2008
Filed Under: Judiciary (system of justice), Government, Health, Healthcare Providers, Health organisations, Health insurance, Hospitals and Clinics
MANILA, Philippines -- The Supreme Court has dismissed the bid of the Philippine Health Insurance Corporation (PhilHealth) to further delay its payment of P14 million in claims by the Chinese General Hospital and Medical Center (CGHMC).
In its 9-page decision, the high court third division told PhilHealth that it should no longer delay payment to CGHMC, which should have been done as early as 2006 when the decision became final and executory.
"After years of continuous wrangling during the execution state, it is unfortunate that the judgment still awaits full implementation. Delaying tactics employed by the losing litigant have prevented early execution.
It is in the interest of justice that we write finis to this litigation," the high court, through Associate Justice Antonio Eduardo Nachura said.
The high court dismissed the appeal filed by PhilHealth accusing the Court of Appeals of committing grave abuse of discretion when it modified the dispositive portion of its resolution to the motion filed by CGHMC.
In its July 12, 2006 resolution, the appeals court said that CGHMC's claim would be paid upon submission of necessary documents for the processing of payments.
CGHMC moved for partial reconsideration saying that such condition of presenting necessary document was never mentioned in the appeals court's original decision.
Thus, the appeals court issued a resolution removing the portion that imposed condition before payment of claim.
The high court said the appeals court's decision was not grave abuse of discretion.
"The term grave abuse of discretion, in its juridical sense, connotes capricious, despotic, oppressive or whimsical exercise of judgment as is equivalent to lack of jurisdiction. The abuse must be of such degree as to amount to an evasion of positive duty or a virtual refusal to perform a duty enjoined by law, as where the power is exercised in an arbitrary and capricious manner by reason of passion and hostility," it said.
"Thus, when seeking the corrective hand of certiorari, a clear showing of caprice and arbitrariness in the exercise of discretion is imperative. In this case, PhilHealth utterly failed to demonstrate caprice or arbitrariness on the part of the CA," the high court said.
The case stemmed when CGHMC filed Medicare claims to the Social Security System (SSS) for services it rendered from 1989 to 1992 worth more than P8 million.
In 1995, upon the enactment of Republic Act 7875 or the law that created PhilHealth, all pending Medicare claims were transferred to it.
PhilHealth only paid CGHMC P1.365-million. CGHMC moved for payment of the remaining P7 million, which PhilHealth had dismissed prompting CGHMC to go to the Court of Appeals.
The appeals court ordered PhilHealth to pay CGHMC P14 million for claims from 1989 to 1992 and from 1998 to 1999.
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