PhilHealth urged to lift cap on dialysis sessions

SYSTEM DOWNTIME / SEPTEMBER 26, 2023Philhealth members visit the agency's office in Quezon City on Tuesday, September 26, 2023. The Philippine Health Insurance Corp. (PhilHealth) assured its members, estimated to number more than 104 million Filipinos, that they can still avail of benefits from accredited health-care facilities despite of an information security incident that was detected early morning of September 22. The agency said it is working to restore their system the soonest possible time. INQUIRER PHOTO / GRIG C. MONTEGRANDE

INQUIRER PHOTO / GRIG C. MONTEGRANDE

MANILA, Philippines — AGRI party-list Rep. Wilbert Lee on Monday urged the Philippine Health Insurance Corp. (PhilHealth) to remove the cap on the number of members’ dialysis sessions it would cover.

Lee maintained that PhilHealth should cover all the dialysis sessions of its members and implement a 20 percent to 30 percent across-the-board increase in member benefits.

According to Lee, PhilHealth should have no limit on the number of dialysis sessions it covers from the current 156 dialysis sessions.

Likewise, he said PhilHealth should also consider increasing the limit for its coverage of chemotherapy, heart bypass surgery and other diseases requiring sustained treatment, as well as diagnostic tests and preventive medical procedures to “ease the burden of patients and their families.”

Lee called for a review by PhilHealth of its case rates, which have not been adjusted to account for inflation and rising health-care costs.

“Case rates are used as the basis for how much PhilHealth would shoulder. This has not been reviewed for more than 10 or 11 years. So, there’s really a need to adjust this,” he explained.

The lawmaker pointed out that with PhilHealth’s existing funds, “they can very well afford to adjust the 20 to 30 percent increase across the board … All packages, all benefits.”

Lee said that while PhilHealth has approved increases for medical treatments including ischemic stroke, hemorrhagic stroke and pneumonia, “increases in all other benefits should also be implemented.”

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