PhilHealth cash advances to SPMC based on last year’s data — DOH

MANILA, Philippines — The Department of Health on Wednesday defended Philippine Health Insurance Corp.’s (PhilHealth) big amount of cash advances given to a Davao-based hospital, saying it is based on 2019 data of its cash claims from the state health insurer.

Health Undersecretary Maria Rosario Vergeire reasoned that the computation of compensation under the PhilHealth’s Interim Reimbursement Mechanism (IRM), in which the Davao-based Southern Philippines Medical Center (SPMC) came out with the lion’s share, is backed by “historical” documentation.

PhilHealth is an attached agency of the DOH, wherein the Secretary of Health sits as it’s chairman.

“They based it on historical figures. It’s the historical claims for three months for the previous year. It was based on last year’s claims or last year’s data,” she told reporters in an online media forum.

Vergeire also pointed out that SPMC has a 1,200-bed capacity, making it one of the biggest hospitals in the country, thus its big compensation.

The hospital also caters to specialized services, such as heart and cancer specialties, due to its high-technology equipment.

“Kung saka-sakaling mas mataas [ang compensation], baka ang kadahilanan ay ang kalakihan ng kanilang hospital, maraming beds, maraming pasyente,” the DOH official said.

“High-tech din sila and they cater to different and varied types of patients,” she added.

In a Senate hearing on corruption issues currently hounding PhilHealth, it was revealed that SPMC received the biggest chunk of cash advances from the state insurer for COVID-19.

It received P326 million, followed by University of the Philippines – Philippine General Hospital in Manila with P263.3 million; Davao Regional Medical Center in Tagum City with P209 million; Vicente Sotto Memorial Medical Center in Cebu City with P204 million; and, Jose B. Lingad Memorial Regional Hospital in the City of San Fernando with P201 million.

EDV