Quimbo wants probe on PhilHealth fund utilization, unpaid claims

INQUIRER FILE PHOTO

MANILA, Philippines — Marikina City Rep. Stella Luz Quimbo is seeking an investigation on the fund utilization of the Philippine Health Insurance Corporation (PhilHealth) as well as the status of the unpaid benefit claims of private hospitals before the state insurance agency.

“I am filing two resolutions to direct the House Committee on Good Government and Public Accountability to conduct an inquiry in aid of legislation on the status of the National Health Insurance Program and the steps PhilHealth has undertaken to improve fund management and utilization; and to investigate the status of the unpaid benefit claims of private hospitals,” Quimbo said during Monday’s session.

Quimbo said that with proper fund management, the budget of PhilHealth should be “sufficient” amid the coronavirus pandemic.

However, Quimbo questioned previous remarks made by PhilHealth officials that the agency’s funds can only last for one year.

“Causing this kind of uncertainty is unacceptable, especially amid a pandemic and an economic recession, when people need social protection the most,” Quimbo said in her privilege speech.

“Isipin na lang po natin ang reaksyon ng ordinaryong Pilipino manggagawa sa balita na mawawalan na ng pondo ang social health insurer… PhilHealth funds must be sufficient, Mr. Speaker, with proper management in place,” the lawmaker added.

Aside from previous issues such as the Interim Reimbursement Mechanism (IRM) and PhilHealth’s case rate system, Quimbo likewise pointed out the private hospitals have complained of PhilHealth’s unsettled claims.

Citing the Private Hospitals Association of the Philippines, Quimbo said unsettled charges have reached an estimated 28 billion pesos for March to December of 2020.

“Ang resulta po ng utang ng PhilHealth – napilitan silang mag-trim down ng manpower dahil wala nang pera ang mga ospital para mag-operate,” Quimbo said.

“Nabawasan na ng kwarto para sa maysakit, na-layoff pa ang mga health workers, kinakabahan pa ang mga Pinoy na baka kulang ang hospital beds para sa COVID patients,” she added.

EDV