Photo by Radyo Inquirer
MANILA, Philippines — A lawmaker is urging the Philippine Health Insurance Corp. (PhilHealth) to settle the P18 billion unpaid claims of accredited hospitals in the country.
Under House Resolution No. 970, Cagayan de Oro 2nd District Rep. Rufus Rodriguez quoted the Philippine Hospitals Association of the Philippines, Inc. (PHAPi) as saying that PhilHealth allegedly owed its members P14 billion as of December 2018 and an additional P4 billion in 2019.
“This is very urgent especially because we are still facing this COVID-19 pandemic and we all need the full operations of our hospitals with the necessary medical personnel,” Rodriguez said.
“We don’t want our hospitals to close, downscale services nor lay off medical personnel because of non-payment of claims by PhilHealth,” he added.
Rodriguez likewise noted that due to the unpaid claims, PHAPi members “have signified their intention ‘to hold back or hold in abeyance’ their accreditation with PhilHealth, which would be very detrimental to the Filipino people.”
PHAPi is composed of 733 hospitals nationwide, with a total bed capacity of more than 44,700 beds.
Rodriguez cited as one of the reasons many private hospitals are struggling to respond to the pandemic is because “they are running out of funds.”
The lawmaker added that some hospitals are even resorting to obtaining emergency loans and retrenchment of some of their employees “to ensure their sustainability.”
“As an example, the University of Sto. Tomas Hospital has reduced its manpower and implemented cost-efficiency measures following ‘significant losses’ inflicted by the COVID-19 pandemic and the delay in PhilHealth payments,” Rodriguez said.
Rodriguez, however, noted that PhilHealth has previously denied that it owed UST and other hospitals large amounts in unpaid claims.
In the same resolution, Rodriguez cited claims that PhilHealth accreditation of some hospitals in Mindanao was revoked over alleged upcasing or the practice of declaring that a patient has a different ailment to get higher reimbursement.
Their accreditation was revoked “when no decision has been reached on the complaints against them and that they were not given the opportunity to be heard in a formal hearing.”
INQUIRER.net has reached out to PhilHealth for a comment but has yet to receive a response as of posting time.