Drilon says PhilHealth to lose P8.3-B for COVID-19 test ‘overpayments’

MANILA, Philippines — The Philippine Health Insurance Corp. (PhilHealth) stands to lose P8.3 billion for the “overpayment” of COVID-19 tests, Senate Minority Leader Franklin Drilon said Wednesday.

Drilon first raised the issue during Tuesday’s Senate hearing on the status of the government’s COVID-19 response, where he questioned the P8,150 amount to be shouldered by PhilHealth under one of its COVID-19 test packages.

“The Philhealth has a package to test. The package is P8,150 per test. In other words, you go to a hospital and you have yourself tested, the Philhealth will pay the hospital P8,150,” Drilon said in an interview on CNN Philippines’ “The Source.”

“Now, what is the cost of the test kits? Our research shows the test kit coming from China would cost P1,500 per test. Then you have the overhead and cost of materials used, you will have another P2,000, and a margin of income of P500.00,” he explained, adding that the “reasonable cost” for the COVID-19 tests would amount to only P4,000.

“That is the cost the Philippine Red Cross charges to patients who avail of the PRC facilities,” he said.

With the government’s goal to test 2 million Filipinos for the coronavirus, Drilon said PhilHealth could potentially lose up to P8.3 billion.

“The Philhealth is reimbursing the hospital for the same work for P8,150. In other words, the overpayment by Philhealth is P4,150 per test. We will test 2 percent of our population or roughly 2 million Filipinos. If you multiply 2 million by P4,150.00, the potential loss is P8.3 billion to PhilHealth. There is a potential overprice of P8.3 billion,” he added.

“Kung iyan po ang babayaran ng Philhealth, ang laki ng overpricing at sa panahon ngayon na hirap ang pamahalaan—may deficit, kulang ang pera, at naghahanap ng malaking pera para sa economic stimulus—nakakalungkot iyan. Babalik ang Philhealth sa amin at sasaibihin ko sa kanila deretso na this is a criminal act. P8 billion ang masasayang at hindi naman kailangan,” Drilon said in a separate interview on Teleradyo.

(That’s why if PhilHealth pays that amount, the overpricing is huge and in a time like this that the government is struggling—there’s deficit, money is not sufficient, and we trying to find source for an economic stimulus—it’s saddening. If PhilHealth will come to us I will directly say to them that that is a criminal act. P8 billion will be wasted).

During the Senate hearing, Health Secretary Francisco Duque III explained that the cost of PhilHealth’s COVID-19 test packages, which range from P2,710 to P8,150, will depend on how the accredited testing laboratories procured the testing kits.

“If testing was not paid for by the DOH (Department of Health) and the test kit used was not donated—which means that the laboratory had spent for all of the cost—it would be about P8,150 per test. If the testing was not paid for by the DOH but the test kit was donated…P5,450 per test. So it’s variable. It changes,” Duque explained.

Meanwhile, the cost of the COVID-19 test would amount to P2,710 if the testing was paid for by DOH and the test kit was donated, the health chief added.

However, Drilon was skeptical about whether PhilHealth will be able to verify how the laboratories conducted the testing and if the test kits were donated or not.

“Depende kung sinasabi nilang nakuha ba nilang libre ang (test kits). Let’s be realistic about it, kapag nag-bill ba sa Philhealth, sasabihin kung donated yung (test kits), etc? Magpapapunta ba ng tao ro’n ang Philhealth?” the senator pointed out on the radio interview.

(It depends if they say its free. Let’s be realistic about it, if PhilHealth is billed, will the hospital say the test kits were donated? Will PhilHealth be able to send their people there to check?)

Duque, during the Senate inquiry, assured Drilon that the said PhilHealth package will be “immediately” reviewed.

/MUF