Duque says PhilHealth to ‘rectify’ IRM on coverage issues
MANILA, Philippines — The Philippine Health Insurance Corporation (PhilHealth) will “rectify” its Interim Reimbursement Mechanism after being questioned in a Senate hearing on why dialysis centers and maternity clinics are eligible to receive funds from the program.
During his opening statement for the Tuesday hearing on alleged irregularities in the state insurance firm, Duque, who sits as chairman of the PhilHealth Board of Directors, said that the IRM is not exclusive for hospitals caring for COVID-19 patients.
“We are in a war against an invisible enemy and COVID-19 patients are not the only casualties in this war. IRM funds are not exclusive to hospitals catering to COVID-19 patients. It is for all HCIs caring for all patients during this pandemic,” he said.
Lacson then asked Duque to point out the provision in the IRM circular that would support his statement.
“Basahin niyo ‘yung rationale, wala kayong makikita dyan. Maski hanapin niyo, wala kayong makikitang pang-justify na saklaw ng IRM particulary Circular 2020-0007 na pwedeng sakupin ang non-COVID cases,” he said.
(Read the rationale and you won’t find it there. Even if you search for it in the document, you will not be able to find anything to justify that the circular covers non-COVID cases.)
The circular, said Lacson, only covers “fortuitous” or unforeseen events.
“’Yung dialysis po a fortuitous event? Fortuitous event ba ang dialysis? Hindi po. Ang maternity care fortuitous event ba ‘yan? Hindi rin po,” he told Duque.
(Is dialysis a fortuitous event? No. Is maternity care a fortuitous event? No.)
He then categorically asked the Health chief if other treatments such as dialysis could be covered by other PhilHealth programs but not under IRM, to which the Health Secretary replied: “Tama po kayo (You are right). We will rectify this for clarity.”
PhilHealth earlier suspended the release of funds under the IRM, an emergency cash advance measure for unanticipated events like natural disasters and calamities, “to review its overall implementation and resolve issues arising from congressional inquiries.”
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