PhilHealth out to resolve reimbursement issues in 2 weeks

PhilHealth spokesperson Dr. Shirley Domingo. Screengrab from DOH online presser

MANILA, Philippines — The Philippine Health Insurance Corporation (PhilHealth) is planning to resolve issues regarding its controversial Interim Reimbursement Mechanism (IRM) within two weeks, after the state insurer suspended its implementation over alleged corrupt practices.

PhilHealth earlier said that the suspension of the IRM was meant “to review its overall implementation and resolve issues arising from congressional inquiries.”

Several senators asked that the program be stopped called for a halt of the program intended to release payments for COVID-19 services to hospitals.

“We hope to be able to address all the issues within two weeks. We have to satisfy all the issues on this IRM bago natin ituloy ito (before we continue this),” PhilHealth spokesperson Dr. Shirley Domingo said in an interview on ABS-CBN’s Teleradyo on Monday.

Amid the ongoing review of the IRM, Domingo maintained that the funds for the program were not pocketed by PhilHealth officials contrary to allegations.

She said the reimbursement fund was properly transferred to beneficiary hospitals.

“Hanggang ngayon ang lumalabas ay ‘yung IRM na iyan ay pinatid ng ating mga opisyales. Hindi po pinatid ‘yun, pumunta ‘yun sa mga hospital,” explained Domingo.

(Until now, it is being implied that  funds for the IRM was pocketed by our officials. It was not. It went to the hospitals.)

“Kaya lang sa dami ng issues na na bring  up, we suspended it muna para maayos natin ‘yung issues na binibring-up against the IRM,” she added.

(But because of the issues brought up, we suspended it for now so we can fix the issues raised against IRM.)

Despite the suspension of the program, PhilHealth earlier clarified that regular COVID-19 inpatient benefits, testing, and community isolation packages will still be available to members.

“Doon po sa members na mangangailangan ng assistance, walang direct effect sa kanila because the effect is on the hospitals na may problem sa financial liquidity nila,” Domingo added.

(It will not have a direct impact on members who will need assistance. Hospitals with financial liquidity problems will be affected.)

IRM is an emergency cash advance measure of PhilHealth to provide hospitals with an emergency fund to respond to unanticipated events like natural disasters and calamities.

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