Hontiveros eyes bill protecting Philhealth from false claims
Robie de Guzman • August 1, 2019 • 1787
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.
MANILA, Philippines – Senator Risa Hontiveros on Tuesday called on power distributor Manila Electric Company (Meralco) to extend its installment-based payment scheme to help its customers cope with economic difficulties due to the effects of the COVID-19 pandemic.
Hontiveros said implementing stricter payment policies might lead to a “disconnected nation” that will make life harder for poor families and derail efforts to revive the country’s economy.
“Hindi maganda na ngayong 2021, maliban sa COVID-19 ay magkaroon din ng epidemiya ng tanggalan ng kuryente sa ating bansa,” she said in a statement.
“Mas mahihirapan umahon ang bansa mula sa pandemya at sa bagsak na ekonomiya kung mas maraming Pilipino ang mapuputulan ng kuryente sa kanilang mga kabahayan dahil sa mga polisiya ng Meralco,” she added.
Meralco earlier announced it has begun sending out notices of disconnection to customers using 201 kilowatt-hours and more per month, and those who are behind in their monthly payments.
The power distributor also said it will be hiking power rates up to P8.7497 per kilowatt-hour (kWh) this year, which means that an average household consuming 200 kWh per month will be charged around an additional ₱55 in their bill.
Hontiveros said the disconnection policy combined with new rate adjustment in the generation charge is on top of the already high regular monthly electricity bills consumers must pay.
“Itong anunsyo ng MERALCO ay mistulang one-two-three punch sa ating mga kawawang consumer, na marami ngayon ay knock-out na sa mga utang, mahal na bilihin at kakulangan ng hanapbuhay dahil sa pandemya,” she said.
“Mas malaki na ang singil ng kuryente, andiyan pa ang panganib na matanggalan ng kuryente kapag hindi nakabayad ng buo. Baka maulit o mas malala ito sa ‘bill shock’ last year na inalmahan ng ating mga kababayan noong 2020,” she added.
Hontiveros expressed hope that MERALCO will stick to its corporate motto of “May liwanag ang buhay,” and work with the government towards programs that will prevent the denial of power services to many Filipinos who are struggling amid the pandemic.
“Electricity is an essential need lalo na ngayong may pandemya. Hindi siguro kalabisan na humiling pa ng makatwirang palugit. Bago ang lahat, kapakanan muna ng ating mga kababayan ang pangunahin na mas dapat inuuna, bago ang kita,” the senator said.
She also advised the power firm to work with the Energy Regulatory Commission (ERC) and explore the possibility of extending its debt restructuring program, which offers flexible or staggered payment options for consumers who are having difficulties paying their monthly power bills so that they could avoid disconnection.
“Siguro naman, hindi hamak na may kapasidad ang MERALCO, ang mga power suppliers at kanilang mga bangko na i-manage ang problema sa utang kumpara sa pinapasan ng mga consumers ngayon,” she said.
“Accommodating this installment-based payment scheme will also ensure that more Filipinos will not get disconnected and will remain as MERALCO’s customers, which will be beneficial in the long run,” she added.
MANILA, Philippines – House Speaker Lord Allan Velasco on Thursday said he has filed two separate bills seeking to grant the president the power to suspend the scheduled increases in the contribution rates of the Philippine Health Insurance Corp. (PhilHealth) and the Social Security System (SSS) in times of national emergencies.
In a statement, Velasco said his twin measures propose to amend Republic Act (RA) 11223 or the Universal Health Care Act, and RA 11199 or the Social Security Act of 2018, which provide for gradual increases in monthly premium contributions in PhilHealth and SSS, respectively.
The bills authorize the president to suspend the implementation of the scheduled increases in premium rates in times of national emergencies “when public interest so requires.”
But this should be in consultation with the secretaries of health and finance departments as chairpersons of PhilHealth and SSS, respectively.
The measures were filed after President Rodrigo Duterte ordered the suspension of the premium rate increase.
Velasco said RA 11223 was enacted in 2018 to ensure that all Filipinos are guaranteed equitable access to quality and affordable health care goods and services, and protected against financial risk.
He said the intent of the law is clear and cannot be overemphasized—Filipinos need and deserve a comprehensive set of health services that are cost-effective, of high quality, and responsive.
The House speaker, however, stressed that the current situation is extraordinary and that Congress must respond accordingly as he called for the swift approval of the bills aimed at alleviating the financial burden faced by many Filipino workers amid the crisis.
“While we recognize that the [PhilHealth] only aims to implement the provisions of RA 11223, imposing a higher premium rate to our kababayans under our current conditions will definitely enforce a new round of financial burden to its members,” Velasco said in the explanatory note of House Bill 8316.
“Suspending the imposition of the new PhilHealth premium rates will provide a much-needed relief from the negative effects of the pandemic and will assure Filipinos that the government is sensitive to their sentiments,” he said.
In filing HB 8317, Velasco said the temporary suspension of the hike in SSS contributions will help the workforce achieve faster recovery from the impact of the pandemic.
“We are witnesses to the negative impact of this COVID-19 outbreak. Under this pretext, the sovereign government must be given the prerogative to bend the rules of the social security law in favor of the greater good,” Velasco said.
He likewise said that increasing the rate of contributions of SSS members will “strikingly undermine the recovery effort of everyone suffering from job losses, wage reduction, business closures, and health-related issues.”
MANILA, Philippines – The Philippine Health Insurance Corporation (PhilHealth) is likely to pay a partial amount of its debt to the Philippine Red Cross (PRC) this week amounting to P265 million pesos.
According to the agency’s spokesperson Rey Baleña, the state insurer’s outstanding balance with PRC is at P728.6 million pesos from its coronavirus disease (COVID-19) testing.
Baleña assures that they have enough funds to pay its debt only that it needs to go through proper procedure.
“Hindi issue dito ang pondo o pambayad. Ito ay ginagarantiyahan natin na meron tayong pondo. In fact nakalaan na ang ating pondo para sa COVID response natin (Funding is not an issue. We guarantee that we have the fund. In fact, we have already allocated our funds for COVID-19 response),” he said.
Meanwhile, PhilHealth said they have returned around P103.4 million worth of defective claims to the PRC.
Baleña said as required by the Commission on Audit (COA) claims must be carefully scrutinized before they are processed.
“Hindi natin sinama sa mga kuwenta na yan yung mga claims na ibinalik natin sa kanila for compliance (We did not include in the computations claims which we returned to them for compliance),” Baleña said.
“Mayroong mga claims na nakita kami na hindi natin pwedeng iprocess, hindi natin pwedeng bayaran sapagkat may mga defect. Sa aming tala ay mga 103.4 million yung worth nung mga claims na ibinalik natin sa kanila for compliance (We identified claims which we couldn’t process for payment because of defects. In our data, it’s about P103.4 million worth of claims that we returned for compliance),” he added.
Apart from COVID-19 tests to frontliners and qualified members, PhilHealth also shoulders isolation expenses when a member is required to go on quarantine. This amounts to P23,000 per member.
In case of COVID-19 positive members or severe COVID-19 conditions, PhilHealth is shouldering about P43,000 to P786,000 worth of expenses depending on the severity of the case. MNP (with reports from Rey Pelayo)
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