200 private hospitals to withdraw accreditation from PhilHealth if claims remain unpaid
Marje Pelayo • May 9, 2018 • 9556
QUEZON CITY, Philippines – The Private Hospitals Association of the Philippines Inc. (PHAPI) said around 200 private hospitals are on the verge of closure and are likely to withdraw accreditation from the Philippine Health Insurance Corporation (PhilHealth) if the insurance company will not pay all their claims by the end of this month.
“This is a voluntary thing. Kung mag-discredit na kami, wala kami bina-violate na batas kasi voluntary (If we decide to withdraw our accreditation, we wouldn’t be violating any law because it’s voluntary)” according to PHAPI President Dr. Rusty Jimenez.
For its part, PhilHealth admitted that the agency owes private hospitals but they want to make sure that all applications are legitimate.
“We are warning some hospitals and doctors na for years ginawang gatasan ang PhilHealth (who for years have been milking Philhealth) by claiming fraudulent claims. In this administration, we will make sure na mahuhuli namin kayo at mapaparusahan (that you will be arrested and penalized),” said Roberto Salvador, PhilHealth board member for Formal Economy Sector.
Payment of claims is the obligation of PhilHealth’s regional vice presidents.
Recently, PhilHealth Interim President and CEO Dr. Celestina De La Serna reshuffled all of the agency’s vice presidents who had been in their position for decades. But after the reassignment, issues of corruption surfaced against Dela Serna.
From the more than 2,000 hospitals, the country only has about 70,000 bed capacity. This is far short from the World Health Organization’s (WHO) standard bed capacity of 100,000 to accommodate 100 million of the country’s population.
Should the concerned hospitals close, one repercussion is that the country’s hospital bed capacity will dwindle even more. – Mon Jocson / Marje Pelayo | UNTV News & Rescue
The Department of Health (DOH) has signed the Implementing Rules and Regulations (IRR) of the Universal Health Care Law.
DOH Secretary Francisco Duque III led the signing of the IRR of the UHC law or the Republic Act 11223 which was witnessed by various health sectors.
The said historical event marks the implementation of the UHC law following its publication.
Under the Universal Health Care law, all Filipinos will be automatic members of Philhealth as direct or indirect contributors and will equally benefit from the no balance billing (NBB) once they have been admitted to the hospitals’ basic or ward accommodation.
Secretary Duque stated, the implementation of the said law will be gradual due to budget constraints.
At least P257 billion will be the required fund for its first-year implementation, yet only P167 billion has been approved.
By the year 2020 to 2024, the department will be needing more than P1- trillion fund for the operation of universal health care.
Duque added that the Philhealth premium rates will increase by 0.25% per year from its current 2.75%.
Philhealth, on its part, will consider giving new benefits for those who are paying their contributions which will be different from the beneficiaries of the Universal Health Care Act. — FSG (from the report of Nel Maribojoc)
Senator Franklin Drilon at Wednesday’s (August 13) hearing of the Senate Blue Ribbon Committee expressed concern on the Philippine Health Insurance Corporation’s ability to pay its members the necessary claims and benefits in the next ten years.
“I do not know how to sustain these in the next 10 years if you keep on incurring a net operating cost. At the end of the day, you might see a collapsing Philhealth,” Drilon said.
This is after the Commission on Audit (COA) released its report of the state insurance’s yearly net operating loss that has now reached billions of pesos.
To which Philhealth vice president for Data Protection, Nerissa Santiago answered: “Those were the years that we increased the benefits without the increase in premiums.”
Other senators were also alarmed by the alleged anomaly and corruption in the agency, including overpayment and ghost dialysis patients.
With this, former Department of Health (DOH) secretary and now Iloilo representative Janette Garin recommended the abolition of the case rate payment scheme and the privatization of some of the operations of the state insurance.
This, she said, will help eradicate corruption.
“Scrap the case rate case. Push through with the individual membership on smaller premium para mawala po ang [so that we will eliminate] ghost members,” Garin said. (from the report of Nel Maribojoc) /mbmf
The Senate Blue Ribbon Committee has set its hearing on the alleged anomaly in the Philippine Health Insurance Corporation (Philhealth) on Thursday (August 8).
In his privilege speech, Senator Panfilo Lacson revealed that Php153-Billion of Philhealth’s fund had gone to overpayments and fraud.
Lacson added that he had requested to send invitations to several Philhealth officials who can testify to the alleged anomaly in the state insurance agency.
“Mga regional senior vice presidents kasi [These are regional senior vice presidents because] many of the information that we got came from insiders from Philhealth themselves,” Lacson said. (with details from Nel Maribojoc) /mbmf
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