PhilHealth admits giving IRM funds to healthcare facilities with pending cases

MANILA, Philippines — The Philippine Health Insurance Corp. (PhilHealth) admitted Wednesday that interim refund mechanism (IRM) funds were given even to healthcare facilities which have pending cases and violations.

During the joint hybrid hearing by the House committee on public accounts and the committee on good government and public accountability, Cavite 4th District Rep. Elpidio Barzaga grilled PhilHealth officials regarding its policies, including its distribution of IRM funds to various healthcare facilities in the country.

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 such as the coronavirus pandemic.

“Policy niyo ba rin sa IRM na ‘yung may mga pending cases, binigyan niyo pa rin ng IRM? Totoo ba ‘yun o hindi? Kahit na may pending cases sa PhilHealth, binigyan niyo rin ng IRM?” Barzaga asked.

(Is it your policy too to give IRM to healthcare facilities with pending cases? Is that true or not? Even though there are pending cases with PhilHealth, you still give them IRM?)

PhilHealth senior vice president Israel Francis Pargas responded: “Yes, Mr. Chair.”

Pargas was then asked why the agency did not opt to deny IRM funds from healthcare facilities with pending cases, at least for now, in order to protect public funds.

But while Pargas was attempting to explain, Barzaga cut him to ask if the decision to provide IRM funds to healthcare facilities with pending cases was put in writing.

Pargas said they made the decision in their executive committee meeting.

In an earlier hearing,  Anakalusugan Partylist Rep. Mike Defensor, who chairs the House committee on public accounts, said that a total of P1.49 billion IRM funds were given to 51 hospitals with pending fraudulent cases.

“Itong 51 hospitals na ito ay may fraud cases na binigyan ng IRM… Bakit hindi ni-resolve ang fraud cases bago nag-release ng IRM?” Defensor asked.

(These 51 hospitals were given IRM funds despite their fraud cases… Why were they not resolved first before the release of the IRM?)

“Kasi sa mata ng publiko, sa mata namin, kung ganito na may mga fraud cases ang mga ospital at institusyon at bibigyan pa rin ng pondo ng PhilHealth, nakakatakot ‘tong batayan, nakakatakot itong ehemplo,” the lawmaker added.

(Because in the eyes of the public, if a hospital or institution has a fraud case and they will still be given funds by PhilHealth, this is scary.)

Defensor argued that hospitals with fraud cases should not be allowed to continue to have IRM funds.

READ: Hospitals with fraud cases received P1.49 B from PhilHealth’s IRM – solon

JE