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Monday, June 17, 2024

PhilHealth gets IATF okay on payment scheme

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The Inter-Agency Task Force on the Management of Emerging Infectious Diseases (IATF) has allowed the implementation of Philippine Health Insurance Corporation’s (PhilHealth) new debit-credit payment for health care facilities in all high and critical risk areas for COVID-19, Malacañang said.

“The IATF approved on April 22, 2021, the application of the Debit-Credit Payment Method (DCPM) of the Philippine Health Insurance Corporation in all high and critical risk areas,” Presidential Spokesperson Harry Roque said in a statement.

Roque said the government task force’s decision would hasten the payment of hospital claims amid rising cases of virus infections in the country.

He said other high-risk and critical risk areas would now also be prioritized in the COVID-19 vaccine allocation, human health resource deployment, and other relevant COVID-19 responses, as applicable.

The PhilHealth's debit-credit payment method initially applied only in Metro Manila and Batangas, Bulacan, Cavite, Laguna, Pampanga, and Rizal provinces.

The IATF also directed the Task Group Treat to utilize projections that “shall identify health capacity needs required to lower health care and intensive care unit utilization rates," he said.

Roque also said PhilHealth had issued a circular on the use of the DCPM to facilitate the settlement of accounts payable to health care facilities during the state of public health emergency arising from the coronavirus pandemic.

The hospitals eligible for DCPM must have no Interim Reimbursement Mechanism Fund balance on record and must also be attending to COVID-19 patients or providing the testing package.

President Rodrigo Duterte earlier directed PhilHealth to hasten the settlement of claims made by hospitals to ensure their uninterrupted operations during the pandemic.

Almost all the hospitals have complained about PhilHealth’s slow payment of claims.

Hospitals awaiting due reimbursement from PhilHealth must not be made to wait any longer as they struggle to protect and save lives amid the pandemic, said Sen. Grace Poe.

The senator made the call following repeated pleas from the Private Hospitals Association of the Philippines Inc. to the state health insurer to expedite and facilitate the release of their valid reimbursement claims.

PHAPI president Jose de Grano said the amount of reimbursement applications with PhilHealth has reached P26 billion to P28 billion as of December 2020.

The amount is an “extrapolation” from their 114 hospital-members which submitted their claims, excluding private health institutions outside Metro Manila, De Grano said.

“This situation weighs heavily on our medical frontliners, patients, and the most vulnerable among our people,” Poe lamented.

“Our hospitals are already bleeding while our medical frontliners put their lives on the line amid the systemic ills that affect our overall capacity to get back on our feet,” Poe reiterated.

Not only private hospitals, but even government COVID-19 frontline institutions are having a hard time claiming PhilHealth reimbursements due to tedious documentation technicalities.

Poe reminded PhilHealth authorities that under Administrative Order No. 23 dated Feb. 21, 2020 of the Office of the President, all national government agencies are directed to hasten the reform of their processes in order to eliminate overregulation.

They shall retain only such steps, procedures, and requirements as may be necessary to fulfill their legal mandates and policy objectives.

All processes in excess, including those which are redundant or burdensome to the public shall be deemed manifestation of overregulation and shall be removed accordingly.

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