PhilHealth
MANILA, Philippines — Sen. Grace Poe pressed the Commission on Audit (COA) on Monday to release its 2020 audit on Philippine Health Insurance Corp. (PhilHealth) to give lawmakers a better picture of its finances amid a threat by several private hospitals to cut ties with the government’s universal health-care program over unpaid insurance claims.
“We need to know exactly how much PhilHealth owes hospitals and health-care workers. They must be paid soon and the government must figure out where to get the funds,” Poe said in a statement.
Poe, chair of the Senate public services committee, noted that the COA had not yet published its latest audit of PhilHealth’s accounting books on its website, unlike its 2020 audit of other government agencies.
The COA report, according to Poe, “will render a credible audit of PhilHealth’s financial condition and see to it that funds are effectively used for the people’s health services needs.”
“The operations of hospitals are at risk. We are still in a pandemic and people are still dying. PhilHealth must not hide or sugarcoat its numbers,” she said.
Based on COA’s 2019 annual audit report on PhilHealth, benefit claims totaled P75.57 billion, nearly double the P39.79 billion benefit claims as of end-2018.
Earlier this month, the Private Hospitals Association of the Philippines Inc. (PHAPi) said a number of hospitals in Metro Manila and in the provinces threatened to dissociate from PhilHealth because of the latter’s failure to settle unpaid COVID-19 claims from 2020.
Jose Rene de Grano, president of PHAPi, said hospitals in Metro Manila, Iloilo, Cagayan Valley and General Santos City were planning to disengage from the state insurer.
“Actually … since August, they owe us more or less around P20 billion and this is all over the country,” he said in an interview on CNN Philippines.
Poe said PhilHealth members would not be able to reap the full benefits of their membership if the hospitals made good on their threat.
“They will have to pay for their medical expenses from their own pockets and hope that the state health insurer will reimburse them,” she said.
“PhilHealth cannot resort to delaying and scare tactics to discourage hospitals from pursuing what’s due them,” Poe added.
Poe said records showed that PhilHealth received 35,147 COVID-19 claims from hospitals in 2020 but only 10,265 of the claims, amounting to P2.5 billion, were paid. INQ