PhilHealth questioned: Why are dialysis, lying-in centers included in IRM for COVID-19?

MANILA, Philippines — Lawmakers at the House of Representatives on Monday questioned the allocation of cash advances under PhilHealth’s Interim Reimbursement Mechanism (IRM) for facilities that do not cater to COVID-19 patients such as dialysis and lying-in centers.

Cavite 4th District Rep. Elpidio Barzaga said that the state health insurer disbursed cash advances to dialysis and private lying-in centers even though they do not cater COVID-19 patients.

The IRM is an emergency cash advance measure of PhilHealth to provide hospitals with an emergency fund to respond to natural disasters, calamities as well as other unexpected events. In this case, the funds are supposed to be for COVID-19 services.

“Ang IRM was intended to address the COVID problem in the country. Bakit natin sinama ang mga dialysis center na alam naman ng bawat isa, hindi sila nagda-dialysis sa mga COVID patients?” he said during a House hearing into the corruption woes surrounding PhilHealth.

(Why were dialysis centers included in the beneficiaries of IRM when we know that they do not cater to COVID-19 patients?)

“Bakit nasama ang mga private lying-in centers, although both of them do not cater to COVID?” the lawmaker further asked.

(Why were private lying-in centers also included?)

During the hearing, PhilHealth executive vice president Arnel de Jesus explained that the funds under IRM are not specifically for COVID-19 cases but its to mitigate the effect of the pandemic to the entire health care system.

He further said that the state health insurer can give cash advances to hospitals under the IRM even though they do not cater to COVID-19 patients.

“Ang disenyo po ng IRM program ay para po sa risk response ng PhilHealth sa magiging posibleng magiging epekto sa buong sistema ng health care,” De Jesus said.

(The design of the IRM program is for the risk response of PhilHealth on the possible effects on the whole health care system.)

“Hindi lamang po ‘yan para sa pag trato o pag gamot ng mga pasyente na apektado ng COVID,” he added.

(It is not only for treating COVID-19 patients.)

Due to the arising issues of corruption, PhilHealth has suspended its IRM after several senators called for a halt to payments to hospitals for COVID-19 services.

JE