Blue Ribbon invites Philhealth officials in hearing on state insurance anomaly

Maris Federez   •   August 6, 2019   •   1058

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

Gierran assures suspension of execs won’t affect PhilHealth functions

Robie de Guzman   •   October 29, 2020

MANILA, Philippines – Philippine Health Insurance Corporation (PhilHealth) president and CEO Dante Gierran on Thursday said the agency will continue rendering its services and functions despite the suspension of eight of its executives.

“PhilHealth assures its members and stakeholders that its mandate and services shall continuously proceed unhampered notwithstanding the challenges that it is currently facing as part of the necessary reforms needed to be undertaken to further improve its services toward the implementation of Universal Health Coverage (UHC) for all Filipinos,” Gierran said in a statement.

Gierran issued the statement after the Office of the Ombudsman ordered the suspension of eight PhilHealth officials over the alleged anomalous release of funds under the Interim Reimbursement Mechanism Policy.

Among those ordered suspended by the Ombudsman are Chief Operating Officer Arnel de Jesus, Executive Vice President Renato Limsiaco, Senior Vice President Dr. Israel Pargas, Area Vice President Gregorio Rulloda, Benefits Administration Section Head Dr. Imelda Trinidad De Vera-Pe, Manager Lolita Tuliao, Fiscal Examiner Gemma Sibucao, and Fiscal Controller Lailani Padua.

The Ombudsman said the suspension order is in relation to the investigation being done on administrative cases of grave misconduct, serious dishonesty and conduct prejudicial to the best interest of the service.

“PhilHealth Management acknowledges the recent Order of the Office of the Ombudsman putting several of its Executive Officers and Personnel under preventive suspension for grave misconduct, gross neglect of duty, and conduct prejudicial to the best interest of the service. We shall abide and implement the suspension Orders accordingly,” Gierran said.

“PhilHealth Management maintains the constitutional rights of its Officers and Personnel on its presumption of innocence until proven otherwise,” he added.

“We trust that the Honorable Office of the Ombudsman will accordingly observe objectivity, justice, and fairness, and allow our concerned Officers and personnel the due process to properly explain and defend themselves,” Gierran further stated.

Red Cross resumes COVID-19 testing after PhilHealth settles P500-M partial payment

Marje Pelayo   •   October 28, 2020

MANILA, Philippines — The Philippine Red Cross (PRC) resumed its coronavirus disease (COVID-19) testing services Tuesday evening (October 27) after the embattled Philippine Health Insurance Corporation (PhilHealth) settled a partial payment of P500-million for its P1.1-billion debt.

In an online press briefing, PRC Chairman Senator Richard Gordon said he already requested all PRC laboratories, including the one at the Ninoy Aquino International Airport (NAIA), to resume the provision of swab testing services to PhilHealth.

Gordon’s announcement was made hours after the state insurer paid half of its arrears.

“So we are ready to test all the people that we have not tested. Iyong mga nasa hotel ngayon, padala nila, tetestingin namin agad iyan (Those staying in hotels, send them to us and we will test them),” Gordon said.

“We are going to have the testing again tonight at the Manila international airport muna, then tomorrow (Wednesday) regular testing will be conducted in full,” he added.

The Senator stressed, however, that though they did not set any deadline for PhilHealth to settle the remaining balance, they will no longer allow any repeat of the financial issues with the agency.

Thus, he said, they will immediately bill the government for future tests.

In a statement, PhiHealth President and CEO Atty. Dante Gierran assured they will expedite the processing of the remaining balance subject to strict compliance with government accounting rules and regulations.

“PhilHealth takes exception to the insinuation that it is reckless and is playing on people’s lives,” he said.

“Its prudence in taking charge of its members’ hard-earned contributions is central to the state health insurer. Its exercise of judiciousness is to protect the people and their funds,” he added.

PhilHealth maintained that it recognizes and assures the accredited laboratories conducting the current OFW RT-PCR tests that it will fast track the processing of its payments upon submission of complete documentary requirements.

Over 100 PhilHealth-accredited centers halt granting of special privileges to dialysis patients

Marje Pelayo   •   October 26, 2020

MANILA, Philippines — Advocate group, Dialysis PH Support Group Incorporated, is calling on the Philippine Health Insurance Corporation (PhilHealth) to address the concerns of its 42,000 members across the country. 

According to the group’s founder and president Reynaldo Abacan Jr., they have been receiving reports from several members that some PhilHealth-accredited dialysis centers are no longer granting them special privileges.

Under the Bayanihan to Recover Act (Bayanihan 2), their dialysis treatment that is being shouldered by PhilHealth should extend until December this year.

“Iyong natanggap naming email mula sa aming mga members, ipinakita nila na mayroong PhilHealth clerk from Region 4 or Batangas na in-email ang bawat center na hindi muna maipapatupad ang special privilege o ang continous dialysis dahil kailangan daw nila ng implementing guidelines or circular,” Abacan said.

(Translation: We received an email from some members citing that a PhilHealth clerk from Region 4 or Batangas sent a mass email to other centers instructing them to stop the special privilege program or the continuous dialysis privilege because they need to receive first an implementing guideline or circular.)

Under PhilHealth’s regular package, a dialysis patient is entitled to 90 dialysis sessions a year which is only up to the month of August. The succeeding months, Abacan said, is shouldered by the patients. This is the reason why they are asking PhilHealth to extend the privilege up to 156 sessions to cover the whole year. This request has been hanging since the year 2015.

They argued that even with special privilege, they are still shelling out additional cash as PhilHealth only covers P2,600 while other centers are charging more than the said amount.

Abacan said there are about 100 dialysis centers across the country that have already suspended the so-called special privilege which has now affected some 30 to 70 patients per center already. 

“Na-cancel ang iba. Iyong iba nakagamit na tapos biglang na-cancel, biglang na-hold. Nagulat iyong mga pasyente. Kasi karamihan sa amin ubos na talaga ang Philhealth at kailangan na nilang magbayad (Others were cancelled. Some were able to start the treatment then all of a sudden, it was cancelled to their surprise. Most of us have used up all PhilHealth discounts so we really need to pay in cash),” he lamented.

“Magkano? Nasa P3,000 kada treatment para lamang maisalang sa dialysis, (How much? It’s P3,000 per treatment that you need to pay just to get into dialysis)” he added.

What worries them, Abacan said, is the possibility that the services they are entitled to are getting caught in the crossfire of issues hounding PhilHealth.

“Ngayon dahil tayo ay under ng pandemic napakahirap ng buhay ngayon. Marami sa amin nawalan ng trabaho, nawalan ng pagkakakitaan (Because of this pandemic, life is tougher. Many of us have lost their jobs, lost their sources of income),” Abacan noted.

“May mga agency na hindi na nagbibigay ng tulong so naging malaking problema sa amin talaga ito (There are agencies that no longer extend assistance, so it has become a big problem for us),” he added.

For now, the group is awaiting PhilHealth’s response to their letter regarding the matter. MNP (with reports from Rey Pelayo)

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