President Rodrigo Duterte has urged Philippine Health Insurance Corp. (Phil- Health) to simplify the process of payment claims of hospitals to 60 days following reported delays.
In a Palace press briefing, Presidential Spokesperson Harry Roque said Duterte made this directive during Monday night’s Cabinet meeting where PhilHealth CEO and President Dante Gierran was present.
“When it comes to filing of claims, PhilHealth was given 60 days to process documents. Despite PhilHealth’s long explanation, the President ordered them to shorten, reconfigure, and simplify requirements for the settling of claims. This includes stretching the limit for late filing,” he said.
Roque said Duterte requested the processing of claims “to be simplified and just let the indigent patient sign so he will be able to go home after his treatment.”
“What is ideal is to compress the process more and not bring more hardship to the sick and indigent Filipino patient and not have to worry about the process,” he said.
In a recent congressional hearing, UST Hospital medical director Marcellus Francis Ramirez said the delay of payments from the state health insurer is “an average of 5-6 months” and that the hospital’s receivables from PhilHealth stood “at more than P180 million and counting.”
Meanwhile, PhilHealth has denied claims that hundreds of private hospitals are facing closure due to delayed payments. It added that reimbursements were processed at an average turnaround time of 41 days with a denial rate of 2 percent.
Cagayan de Oro Rep. Rufus Rodriguez quoted claims by the Philippine Hospitals Association of the Philippines (PHAP), composed of 733 hospitals, that PhilHealth owed its members P14 billion as of December 2018 and P4 billion at the end of 2019.
Roque said Gierran vowed to meet members of the PhilHealth board to implement the President’s directive.
Meanwhile, Roque said the inter-agency task force investigating irregularities in PhilHealth has submitted to Duterte a new report that includes plans to file complaints against PhilHealth officials and medical practitioners involved in anomalies.
“They submitted their report to the President and according to Secretary Meynard Guevarra last night, the expanded task force will file complaints before the Ombudsman against officials of the PhilHealth and some medical practitioners who are accomplices in anomalies,” he said
The task force submitted its 177-page initial report to Duterte last September.
Formed last August 7, the task force conducted seven hearings where it received the testimony of 14 witnesses, reports and summaries of cases, and reports and recommendations of other bodies including the Senate.
The task force called out the state firm's alleged “foot-dragging” in going after thousands of fraud cases involving its employees and some healthcare institutions and has flagged the low and slow rate of prosecution of cases by PhilHealth's legal office. Vito Barcelo
Duterte earlier ordered Gierran to find the officials and persons responsible for irregularities in PhilHealth and has directed a reshuffle of the state firm's regional vice presidents.