‘Inexcusable:’ Senators press PhilHealth to settle unpaid claims to hospitals

The main office of PhilHealth in
Pasig City. INQUIRER file photo / LYN RILLON

MANILA, Philippines — Senators on Tuesday once again called on the Philippine Health Insurance Corp. (PhilHealth) to pay unpaid hospital claims immediately, with one calling on the Anti-Red Tape Authority (ARTA) to determine why the state insurer has been “slow” to reimburse.

The delay in the reimbursement of claims has led some hospitals to threaten to leave PhilHealth.

READ: Up to hospitals, docs whether to cut ties with PhilHealth – PHAPI

“PhilHealth must pick up the slack in settling its mounting obligations to hospitals that compromise our healthcare system,” Senator Grace Poe said in a statement.

“It is unjust for our frontline institutions to continue waiting for years seemingly with no end in sight on when they can be reimbursed,” she added.

She called on PhilHealth to formulate an “aggressive catch-up plan” to settle the reimbursement of claims.

“The delay in payment could force hospitals to downsize or worse, halt operations, to the detriment of their workers who will lose jobs, and our people who cannot anymore take a heavy beating from the pandemic,” she warned.

“As this unfortunate situation persists, our health system becomes more vulnerable to being overwhelmed, especially in a pandemic,” Poe added.

Senator Sonny Angara, for his part, pointed out that hospitals have long been complaining about the claims still owed to them.

He stressed the need for PhilHealth to settle these claims to prevent a “systems failure” on the country’s healthcare system, leading to the possible closure of some hospitals.

“Taun-taon nagbabayad ang milyon milyong Pilipino ng automatic deductions mula sa sweldo nila, maliit o malaki man ang sahod; in addition, may P70 billion na dagdag subsidiya ang national government sa pondo ng Philhealth itong nakaraang taon,” said Angara, chairman of the Senate finance panel.

(Every year, millions are automatically deducted from the salaries of Filipinos, regardless of the amount they earn. In addition, the national government allocated a P70-billion additional subsidy to PhilHealth last year.)

He then urged ARTA to look into the process of PhilHealth and determine the reason behind the “slow” payment of claims to hospitals.

“Nasa ilalim tayo ng public health emergency kaya’t inexcusable o ‘di katanggap tanggap itong nangyayari ngayon,” he added.

(We are under a public health emergency. That’s why what’s happening is inexcusable.)

Senators Risa Hontiveros and Imee Marcos also made similar calls for PhilHealth to pay what it owes to hospitals “within a reasonable time period.”

“Meanwhile, I am also appealing to our private hospitals to remain committed to ensuring access to affordable healthcare. The government, given its limited capacity to provide hospital care, should explore options to provide crucial financial aid to hospitals at risk,” Hontiveros added.

For her part, Marcos warned that the Universal Health Care Act and PhilHealth itself may “lose their purpose if hospitals make good on their threat to boycott the agency and no longer renew their accreditation next year.”

“At this time when people have neither jobs nor money, who will pay for their medical expenses if hospitals are no longer registered with PhilHealth? There are almost 95 million direct and indirect contributors to PhilHealth who are anxious about losing their benefits,” she said.

“PhilHealth must pay at once the billions it owes, and at the same time file cases against those engaged in upcasing if there is proof. The courts will anyway return to PhilHealth the amount that was paid and with accrued interest, if hospitals are found at fault,” Marcos added.

PhilHealth has yet to respond to INQUIRER.net’s request for comment on the senators’ call.