House panel urges PhilHealth to rectify ‘mistakes’ in benefit package circular

Health committee chair and Quezon Rep. Helen Tan grills PhilHealth executives during a hearing held Tuesday. Sreengrab from HoR livestreaming

MANILA, Philippines — After hours of questioning officials of the Philippine Health Insurance Corporation (PhilHealth), the House committee on health moved to urge the agency to rectify the “apparent mistakes” in the circulars on coverage of benefit package for COVID-19 patients.

During its online hearing on Tuesday, the House committee on health adopted House Resolution No. 1966 urging PhilHealth to “rectify the apparent mistake in the issued circulars regarding the COVID-19 benefit package.”

The resolution also called on PhilHealth to “review the soundness of the issuances to ensure just and fair policies for the benefit of the Filipino people.”

One of the central focuses of the hearing was PhilHealth Circular No. 2021-008, which states that the coverage of COVID-19 inpatient packages are for confirmed cases only and probable cases can instead avail of an intermediate package.

But lawmakers questioned the retroactive clause of the circular, asking why the circular covers admissions starting November 26, 2020, when the circular was only issued in June 2021.

“This will cause huge losses to hospitals that have already rendered service and processed the claims as well as patients who were already entitled to such claim prior to the issuance of PhilHealth Circular 2021-008,” Health committee chair and Quezon Rep. Helen Tan said.

“Millions of COVID-19 probable claims are in danger of being denied as a result of PhilHealth’s turnaround causing huge losses to health care facilities which clinically managed a probable COVID-19 case and eventually causing financial hardship to the COVID-19 patient whose claim will be denied due to fear of prosecution of signatories involved in the approval of the claims,” she added.

PhilHealth president Dante Gierran said he will recommend to the board of directors to reconsider the circular.

“This representation is also a member of the board and hearing already a statement from this committee which has an oversight power on matters like this, I would certainly—would recommend to the board being the highest authority in the corporation to have this matter be taken into consideration for favorable action,” Gierran said.

EDV