Fast-track payment of claims from hospitals, palace tells PhilHealth

THE PRESIDENTIAL palace on Monday urged the Philippine Health Insurance Corp. (PhilHealth) to fast-track the payment of claims from private hospitals, which have threatened to cut ties with the state insurer.

PhilHealth’s failure to pay the claims would deprive Filipinos’ access to healthcare services, presidential spokesman Herminio L. Roque, Jr. said at a televised briefing on Monday. “Pay what is due,” he added.

Private hospitals said they would cut ties with the state insurer after it refused to pay hospital claims under investigation worth P13.8 billion.

Mr. Roque also asked PhilHealth chief Dante A. Gierran why only one official was removed over fraudulent hospital claims. “That is unbelievable.”

Mr. Gierran, who used to head the National Bureau of Investigation, was appointed PhilHealth chief last year after the state corporation was accused of paying billions of pesos in anomalous hospital claims.

Meanwhile, Senators Mary Grace Poe-Llamanzares and Christopher Lawrence T. Go asked PhilHealth and hospital groups to reach a middle ground.

“PhilHealth must not resort to a sweeping mechanism that could further delay the settlement of legitimate obligations,” Ms. Llamanzares said in a statement.

Mr. Go said that the government insurer should work with hospital groups to resolve the issues.

Ms. Llamanzares said a number of hospitals are reeling from financial distress due to unpaid claims, putting in peril their capacity to serve Filipinos covered by the state health insurance. “The delays or nonpayment of claims are also sapping the resources of hospitals to pay their medical frontliners.”

Also on Monday, Party-list Rep. Bernadette Dy-Herrera said PhilHealth had “overstepped its powers” in suspending the payments. She said the payment suspension would have serious repercussions for the government’s COVID-19 response efforts.

Jaime A. Almora, president of the Philippine Hospital Association, told a House of Representatives hearing on Aug. 17 PhilHealth had denied P13.8 billion out of P86.08 billion worth of claims by private hospitals.

Ms. Herrera urged PhilHealth to discuss the issue with healthcare providers and consider the welfare of its members who will be affected by the suspension.  Kyle Aristophere T. Atienza, Alyssa Nicole O Tan and Russell Louis C. Ku

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