DOJ: PhilHealth’s IRM parameters ‘stretched bit too much’

MANILA, Philippines — The parameters on the implementation of the interim reimbursement mechanism (IRM) of the Philippine Health Insurance Corp. (PhilHealth) during the coronavirus pandemic were “stretched too much” and “not followed,” an official of the Department of Justice (DOJ) said Thursday.

During the hearing of the House committee on public accounts and the committee on good government and public accountability, DOJ Undersecretary Adrian Sugay said they are eyeing to finish the complaint in relation to the IRM implementation within the week.

“I think in this case, initially what we have found is that in the implementation of the IRM with regard to COVID-19 and the pandemic, medyo marami kaming nakitang issues (we saw a lot of issues),” Sugay said.

“I think the parameters were stretched a bit too much, maybe many of them went beyond the parameters clearly set by precedents with regard to the implementation of the IRM as well as the implementing rules and regulations or the circulars which have been in place with regard to the IRM, as well as the other, special privileges [stated in the] PhilHealth circular which are made available to healthcare institutions in times of pandemic, there’s a calamity, or there’s a fortuitous event,” he added.

Sugay said that while the parameters on the implementation of IRM were very clear, they were not followed.

“What we found so far ay hindi nasunod itong parameters na ito. And we hope to finish the complaint within the week. So with regard to the IRM, we’re almost wrapping up with regard to the complaint,” Sugay said.

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.

PhilHealth earlier announced the suspension of the IRM after several senators called for its temporary halt amid allegations that the release of funds for the country’s coronavirus response was marred with irregularities.

Meanwhile, Sugay said they will also finish the investigation with regard to the information technology-related issues hounding PhilHealth.

“One of our undersecretaries who is a procurement expert is looking into this very carefully, kung ano yung hindi nasundan initially with regard to procurement process,” Sugay said.

(One of our undersecretaries who is a procurement expert is looking into this very carefully, especially with regard to the procurement process.)

“So these are matters that will be looked into pagdating sa (when it comes to) IT concerns and we are also preparing the complaint for that,” he added.

The Commission on Audit earlier flagged the IT project for being rife with irregularities.

COA and PhilHealth’s resident auditors saw as “anomalous” the planned procurement of various equipment worth P734 million, which was not contained in the original budget proposal submitted by the state insurer.