Image from PhilHealth Facebook
MANILA, Philippines — Malacañang on Monday directed the Philippine Health Insurance Corp. (PhilHealth) to pay all claims of private hospitals as some of them are mulling to cut ties with the state insurer.
Three hospital groups earlier said they were considering disengaging with PhilHealth after the state insurer released a circular temporarily suspending the payment of claims.
PhilHealth had justified the circular as a fraud-control measure after the agency was investigated for its P153.7 billion in losses from 2013 to 2018.
Presidential spokesperson Harry Roque said PhilHealth should pay all the hospitals’ claims as hospitals’ disengagement “has the potential of derailing the universal health care law.” Roque noted that private hospitals provide the bulk of health care services in the country.
While recognizing that there are indeed anomalous and fraudulent claims, Roque said the PhilHealth should investigate the claims instead of threatening to “blacklist” hospitals.
“Ang gobyerno sa pamamagitan ng PhilHealth ang siyang bibili ng lahat ng medical goods and services kaya itong banta nila [private hospitals] na sila ay titigil na magbigay serbisyo at magdi-disengage sa PhilHealth, that has the potential of derailing the universal health care law,” he said in a briefing.
(The government through PhilHealth is the one that will buy medical goods and services as opposed to nationalizing private hospitals. So their threat to disengage from PhilHealth has the potential of derailing the universal health care law.)
“Ang panawagan ko sa PhilHealth, magbayad kayo ng mga dapat bayaran. Totoo, maraming ma-anomalyang mga claims. Ang dapat gawin diyan, litisin ang magsusumite ng mga fictitious claims at mga ma-anomalyang claims, ‘wag natin gamitin ‘yung blacklisting o ‘yung threat of blacklisting dahil hindi kakayanin ma-implement ang universal health care law na pang-gobyernong hospital lamang ang magbibigay ng serbisyo lalung lalo na sa panahon ng pandemya,” he added.
(I call on PhilHealth to pay all that is due. Yes, there are anomalous claims but this should be investigated. Don’t use the blacklisting because the government cannot implement the universal health care law on government hospitals alone, especially in a time of a pandemic.)
Roque also called on PhilHealth chief to sack erring officials allegedly involved in fraudulent hospital claims.
“Ang panawagan ko kay Atty. Gierran, bakit iisa pa lang ang natatanggal sa PhilHealth dahil sa mga anomalya, nagresign pa? Ang ibig mo bang sabihin lahat ng mga anomalya sa nakalipas, eh narariyan pa rin lahat ng tao na responsable diyan at ni isang tao sa PhilHealth hindi dapat sibakin? Hindi kapani-paniwala ‘yan,” he said.
(Why is there only one who was removed from their posts despite being involved in anomalies? And that one resigned. Do you mean to say that all those involved in previous anomalies are still there and they shouldn’t be fired? That’s unbelievable.)