200 private hospitals to withdraw accreditation from PhilHealth if claims remain unpaid

Marje Pelayo   •   May 9, 2018   •   9001


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

Privatization, case rate payment scheme removal, recommended amid PhilHealth anomaly issue

Maris Federez   •   August 14, 2019

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

Blue Ribbon invites Philhealth officials in hearing on state insurance anomaly

Maris Federez   •   August 6, 2019

Senator Panfilo Lacson

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

Court junks estafa case vs Wellmed owner, officials

Aileen Cerrudo   •   August 5, 2019

The Quezon City Regional Trial Court (RTC) has dismissed the estafa case against the owner and several officials of Wellmed Dialysis Center due to a technicality.

Branch 219 of the Quezon City RTC sided with the motion of Wellmed owner Bryan Sy to dismiss the complex crime of estafa filed by the National Bureau of Investigation (NBI) and the Philippine Health Insurance Corporation (PhilHealth).

The case was filed by whistleblowers, Liezel Aileen de Leon, Edwin Roberto, and others due to anomalous PhilHealth transactions.

However, the Quezon City RTC said this does not mean the accused are innocent.

“Finally, the court emphasizes that the dismissal of these cases has nothing to do with the guilt or innocence of the accused,” according to Judge Janet Abergos-Samar of the Quezon City RTC Branch 219.

Meanwhile, the lawyer of the two whistleblowers, former Presidential Spokesperson Harry Roque said in a statement the dismissal “will derail all efforts to cleanse PhilHealth preparatory to the implementation of the Universal Health Care Law, which I authored in the 17th Congress.”

“The whistle blowers remain firm in their conviction to expose the truth and to seek justice for the Filipino people,” he added.—AAC (with reports from Mai Bermudez)


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