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Thursday, March 28, 2024

PHAPI urges BBM to fix fiscal mess at PhilHealth

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The Private Hospitals Association of the Philippines Inc. (PHAPI) on Saturday urged the incoming Marcos administration to fix the reimbursement system at state-run Philippine Health Insurance Corp. (PhilHealth).

PHAPI president Dr. Jose De Grano said private hospitals have been relying primarily on PhilHealth’s reimbursement mechanism, but some hospitals’ claims were delayed or have yet to be released.

Private hospitals mulled cutting ties with PhilHealth over unpaid 2020 COVID claims.

“Doon sa naging karanasan namin noongnakaraang taon, ilang taon sa PhilHealth, ’yun ang palagay kong kailangang pagtuunan ng pansin n susunod na administrasyon na sana ay hindi magkaroon tayo ng problema sa ating claims sa PhilHealth,” De Grano said in a televised briefing.

“Kung maayos po natin ang organisasyon ng PhilHealth nang sa ganoon ay makaayon dito sa mga hinihiling ng ating mga pribadong ospital, siguro government hospitals, palagay ko maganda ’yun na maisakatuparan at sa gayon po ang ating healthcare system ay magiging maganda para sa susunod na anim na taon.”

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In late December last year, some hospitals threatened to cut ties with the PhilHealth, citing millions of pesos in unpaid claims that accumulated over the past few years.

PhilHealth president and CEO Dante Gierran has admitted that the agency owed hospitals more than P25 billion, and it planned to settle the debts by June.

But De Grano said PhilHealth has already communicated to them and the government-owned insurance firm was still paying dues. For this reason, described their relationship with PhilHealth as “fair”.

“Siyempre ang ine-expect namin na pagbabayad ng claims, hindi pa nabibigay lahat lalo na ’yung mga hospitals na sinasabing malalayo,” he said.

“Hindi pa po kumpleto ’yung kanilang kine-claim pero doon sa nakaraang buwan nakapagbigay naman ang PhilHealth ng at least ibang kabayaran para maipagpatuloy ng mga ospital yung kanilang operasyon.”

Gierran had attributed the slow payment of claims to the lack of manpower and information technology caused by the pandemic.

As of January 7, the agency has already released P12.05 billion to 444 hospitals via the Debit-Credit Payment Method (DCPM), he added.

PhilHealth had faced corruption issues, with allegations about officials supposedly pocketing P15 billion in public funds, approving overpriced projects, and releasing funds to favored hospitals.

Gierran had said the P15 billion “missing” funds have already been accounted for.

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