Hontiveros eyes bill protecting Philhealth from false claims

Robie de Guzman   •   August 1, 2019   •   715

Senator Risa Hontiveros

MANILA, Philippines – Opposition Senator Risa Hontiveros on Wednesday said she is planning to file a bill seeking to protect the Philippine Health Insurance Corp. (Philhealth) from fraudulent activities such as overpayments and false claims.

Hontiveros said the bill, which will be called the PhilHealth Insurance False Claims Act, is seen to deter and minimize fraud notwithstanding the penalties provided for under the Universal Health Care (UHC) Act.

The senator said she will file the bill after Senator Panfilo Lacson revealed that the Philhealth incurred billions of losses due to alleged fraudulent benefit claims involving corrupt health officials.

“The seriousness and disturbing nature of these allegations should prompt a review of PhilHealth’s anti-fraud mechanisms,” she said in a statement.

“Every peso lost to corruption in our health programs would mean that a citizen is deprived of potentially life-saving medication or treatment. Corruption makes our people unhealthy and even threatens their lives,” she added.

Under the bill, Hontiveros proposes to improve PhilHealth’s fraud detection mechanisms, including a shift from the current case rate payment to a diagnosis-related grouping provider payment mechanism, and providing support to PhilHealth staff who flag anomalies.

She also wants to revisit the penalty of suspending hospital operations and seriously consider imposing monetary penalties that are at least three times the amount of detected fraud.

Hontiveros said she was particularly alarmed over the report that PhilHealth continues to overpay fraudulent hospitals and clinics via “overstaying” or “ghost” patients.

“Mukhang tuloy-tuloy ang mga anomalya mula sa hakot operation ng mga eye clinics, ghost dialysis patients hanggang sa mga kontrobersyal na repayments. Hindi maaari ito,” she said.

“Defrauding the government and depriving countless Filipinos of access to health services is an unacceptable and criminal misuse of public money. Every single peso under our health programs could potentially spell the difference between life and death for our constituents. Let us make sure that it is well spent and will not end up in the pockets of the corrupt,” she added.

DOH signs IRR of Universal Health Care Law

Freema Gloria   •   October 10, 2019

Patients receive medical attention inside a hospital in the town of Isulan, Sultan Kudarat province. EPA-EFE/JEOFFREY MAITEM

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)

Bill seeking to protect interns against exploitation pushed in Senate

Robie de Guzman   •   September 10, 2019

MANILA, Philippines – Senator Risa Hontiveros has filed a bill seeking to protect interns against exploitation from companies and promote their professional growth.

The Senate Bill No. 994 or the Interns’ Rights and Welfare bill lists down the responsibilities of host training establishments (HTE) to their interns, with the end view of establishing a proper and relevant experience for them.

“Internship is for students and young people to learn more about the workplace and to deepen their craft. Internship is not an excuse for employers to take advantage of cheap or free labor,” she said in a statement.

“Dahil walang employer-employee relationship, maraming nagiging kaso ng exploitation at kawalan ng professional growth,” she added.

The proposed measure requires any employer who chooses to host interns to come up with a contract and program that details the professional training of interns. It also seeks to strengthen schools vetting process for HTEs.

“Schools have a responsibility to accredit reputable HTEs for their students and to ensure that students do not undergo internship in companies with dubious internship programs,” the senator said. “Hindi pwedeng ipag-intern mo yung mga estudyante sa mga kumpanyang may questionable labor practices na pwedeng maglagay sa kanila sa alanganin.”

The measure also seeks to put a cap on internship hours.

Internship should not exceed 300 hours, nor last for more than 6 months in the government sector while in industry-based internships that are more technical in nature, internship hours are capped at 660 hours per semester, which is equivalent to 15 units per term.

The bill also protects all interns from any form of workplace abuse and harassment.

Senate Bill No. 994 contains the following key provisions:

  • providing basic benefits and remuneration (75% of the prevailing minimum wage in the region for private companies and 75% of Step 1 Salary Grade 1 for interns in the public sector);
  • appropriating funds for government agencies to host interns in order to promote public and civil service among young people; and
  • a grievance mechanism to address any violation of basic interns’ rights.

“Preparing our young people for the workforce includes a viable internship program that centers on their professional growth,” Hontiveros said.

“Our country’s policy on interns reflects how we value humane and decent work. It is time to put a stop to internship horror stories. It is time to stop the abuse and exploitation of interns as part of our education and labor policies,” she concluded.

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

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