Duque to revamp Philhealth’s accreditation unit

Robie de Guzman   •   June 11, 2019   •   2033

MANILA, Philippines – Health Secretary Francisco Duque III is looking to revamp the accreditation unit of the Philippine Health Insurance Corp. (Philhealth) in relation to the “ghost dialysis” controversy.

At a press briefing on Tuesday, Duque questioned the committee for its alleged inaction on the recommendation to revoke the accreditation of WellMed Dialysis Center, the facility being linked to the issue.

The Health official said they have already identified the members of the accreditation unit who may have committed negligence with regard to the controversy.

“It is the accreditation committee where we think nagkaroon talaga ng oversight. That is the subject of the ongoing investigation,” he said.

Duque added that they are also looking into other operating committees within the Philhealth Central office that might also be involved in the multi-million ‘ghost dialysis’ claims issue.

“There is a possibility of connivance, I think, because it’s hard to believe that this will just be happening without somebody from the inside who knows how to circumvent, how to go around the processes of Philhealth,” he said.

Duque also directed Philhealth to identify which among the more than 7,000 claims made in 2018 may be considered as anomalous or fraudulent.

He also ordered for the list of hospitals and other medical facilities that might have asked Philhealth for dialysis payments of already deceased patients.

“I have instructed Philhealth to identify for 2018 7, 213 cases have been filed and how many of those cases account for ghost claims. Kasi marami tayong fraudulent claims, meron tayong multiple filing of claims,” Duque said.

“So ito, talamak din po ito. Ito pong ating mga inappropriate treatment or procedures being done na hindi sang-ayon sa clinical practice guidelines,” he added.

On Monday, President Rodrigo Duterte asked for the courtesy resignation of some Philhealth officials amid the ongoing investigation into the controversy.

Duque said the President expects them to tender their resignation within Tuesday.

However, the health official said he will seek to clarify with the President on who among these executives have been instructed to resign in line with the chief executive’s order to allow the state-run firm to start on a clean slate.

He added that Philhealth officials will have to stay until their resignation letters are formally accepted by the Office of the President. (with details from Aiko Miguel)

Universal Health Care Law must be implemented as approved — Palace

Marje Pelayo   •   June 19, 2020

MANILA, Philippines — The government must not defer the implementation of the Universal Health Care (UHC) Law, according to Malacañang.

Otherwise, it will constitute a violation of the Constitution, Presidential Spokesperson Secretary Harry Roque said.

Roque specifically addressed the matter to the management of the Philippine Health Insurance Corporation (PhilHealth) after issues of anomalies surfaced against the agency. 

He said should the agency fails to adhere to its mandate, it would compel President Rodrigo Duterte to for a new leader who will be more capable to implement the law.

Ang akin pong panawagan sa mga namumuno sa Philhealth. Kung hindi ninyo po mapapatupad ang isang batas na certified as urgent ni President mismo, dahil na ang nais niya magkaroon ng libreng gamot ang lahat ng Pilipino, gaya ng ginawa niya sa Davao, siguro po hahanap na lang ng iba na magpapatupad niyan,” Roque said. 

[I call on the leadership of PhilHealth. If you will not implement the Law that the President himself certified as urgent as he intends to provide free medicine to all Filipinos similar to what he did in Davao, perhaps he would opt to find another person who will do get the job done.]

Roque, however, stressed that his statement did not intend to threaten PhilHealth President and CEO Ricardo Morales. 

For his part, Morales assured that the agency has enough funds to support the claims of all members. 

“We started the year with about P130-B reserved (fund). So hindi totoong walang pera ang [It’s not true that PhilHealth is out of fund] but we were asking for P153-B for 2020,” Morales explained. 

Ang natanggap namin is P71-B. So may shortfall iyon pero kaya pa ng reserves namin iyon [We received P71-B, so yes, we have shortfall but our reserves can still back us up]. We’re okay for this year up to about early next year. We’re fine,” he assured.

PhilHealth is constantly coordinating with the Department of Finance (DOF) and the Department of Budget and Management (DBM) in case an adjustment is needed in the agency’s budget for next year. MNP (with reports from Rosalie Coz)

Drilon opposes Philhealth bid to delay implementation of Universal Health Care Law

Robie de Guzman   •   June 18, 2020

MANILA, Philippines – Senate Minority Leader Franklin Drilon has opposed the Philippine Health Insurance Corporation’s (Philhealth) appeal to postpone the full implementation of the Universal Health Care (UHC) Law even amid the slump in collections this year due to the novel coronavirus disease (COVID-19) crisis.

In a statement issued on Wednesday, Drilon said the UHC law is “critical” in the fight against COVID-19, and delaying its implementation is wrong.

“To halt the implementation of a law that would promote access to affordable care, strengthen our primary health care and make our people healthy to fight the virus is a step in the wrong direction,” he said.

“If COVID-19 taught us one thing, it is that we need to keep people healthy and we have to prepare for the next pandemic. UHC is the key,” he added.

While Drilon recognized the need to address Philihealth’s precarious position for it to be able to sustain its funding, he said it should not be at the expense of the people who are relying on the UHC for their health needs.

He added that the COVID-19 pandemic reveals the weaknesses and inequity in the current healthcare system, which the law seeks to address.

The Senate Minority Leader also expressed his concern that postponing the full implementation of the UHC could “discourage poor people from seeking hospital treatments or primary health care even if they experience COVID-19 symptoms.”

Drilon said the implementation of UHC is sourced from the Philippine Amusement and Gaming Corporation and Philippine Charity Sweepstakes Office, premium contribution of members, annual appropriation of DOH under the General Appropriations Act, and National Government subsidy to Philhealth.

Drilon said he has already called on the Department of Budget and Management to increase funding for the health sector in the National Expenditure Program for 2021.

“If we learned anything about the onset of the pandemic, it is that the health sector must get a big part of the budgetary pie,” he said.

The health of the people is the State’s responsibility,” he added.

Deadline sa pagbabayad ng Philhealth contribution para sa self-paying members, pinalawig hanggang June 30

Robie de Guzman   •   June 16, 2020

MANILA, Philippines – Pinalawig ng Philippine Health Insurance Corporation (Philhealth) ang deadline sa pagbabayad ng kontribusyon para sa self-earning members hanggang Hunyo 30.

Sa isang pahayag ngayong Martes, sinabi ng Philhealth  na ito ay upang mabawasan ang isipin sa bayarin ng mga miyembro nito sa gitna ng novel coronavirus disease (COVID-19) pandemic.

Sinabi rin ng ahensya na maaari pa rin namang gamitin ang flexible at deferred payment scheme kung nanaisin ng overseas Filipino workers (OFW).

Sa Philhealth Advisory No. 2020-038, sakop din ng extension ang pagbabayad sa kontribusyon para sa professional practitioners at mga saklaw ng group enrolment schemes.

“They may pay their contributions at any of its accredited collecting agents (ACAs) and PhilHealth local health insurance offices (LHIOs) nationwide,” ayon sa ahensya.

Sinabi rin ng state insurer na maaaring magbayad ang mga employer ng premium remittances hanggang June 22 para sa mga buwan ng Pebrero, Marso at Abril.

“Employers in the public and private sectors have also been advised that their premium remittances for the applicable months of February, March and April 2020 can be paid until June 22, 2020 without interest, in line with the Bayanihan to Heal as One Act,” ani ng Philhealth.

Inanunsyo rin ng ahensya na maaaring magbayad ng inisyal ang mga OFW ng kanilang remium gamit ang dating rate na P2,400 at bibigyan sila ng isang taon para kumpletuhin ang natitirang balanse.

Nakapaloob ito sa Philhealth Advisory No. 2020-037 na nagsasaad ng mga panuntunan para sa overseas Filipino workers na apektado ng pagpapatupad ng Universal Health Care Act.

“It said that OFWs “may pay at the previous rate of P2,400 as initial payment” and are “granted One year or 12 months from the date of their initial payment to complete their balance for the year,” ayon sa Philhealth.

Nilinaw rin ng ahensiya na sa ngayon ay boluntaryo ang pagbabayad ng premium para sa mga OFW sa gitna ng pandemya ngunit aplikable pa rin ang mga probisyon ng Universal Health Care law ukol sa premium payment ng mga OFW hangga’t hindi ito inaamiyendahan ng Kongreso. – RRD (mula sa ulat ni Correspondent Aiko Miguel)

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