The Philippine Health Insurance Corp. (PhilHealth) assured the public on Friday that it would continue to provide coverage to its members, including those who had been struck by COVID-19.
PhilHealth President and CEO Ricardo Morales sought to allay concerns that the release of benefit packages may be disrupted due to the investigations of the state insurance company by Congress, the Department of Justice, and Malaca帽ang.
鈥淥ur offices are ready to serve our clients nationwide,鈥� Morales said in a statement.
He added that since every Filipino is a PhilHealth member under the universal healthcare law, everyone will 鈥渃ontinue to enjoy PhilHealth coverage for needed treatments and procedures.鈥�
Concerns over a possible suspension of COVID-19 coverage followed PhilHealth鈥檚 announcement that it was temporarily halting the implementation of the interim reimbursement mechanism (IRM) 鈥渢o review its overall implementation and resolve issues arising from congressional inquiries.鈥�
The IRM is a special P30-billion fund for payments to hospitals and other medical facilities during times of calamities such as the ongoing COVID-19 pandemic.
Ricardo Morales
Not on hold
PhilHealth on Friday denied on its Twitter and Facebook accounts that the suspension of the IRM meant payments for coronavirus disease (COVID-19) cases would be put on hold.
鈥淐ontrary to one misleading headline today, PhilHealth is not suspending its COVID-19 payments for inpatient, testing, and community isolation packages,鈥� PhilHealth said in apparent reference to the Inquirer.
鈥淎ffected patients are assured of continued entitlement to these benefits. What is suspended is the IRM for implementation review. The agency maintains that IRM is legal and necessary for the country鈥檚 overall COVID-19 response,鈥� it added.
Sen. Panfilo Lacson, who set off the Senate investigation along with Senate President Vicente Sotto III, warned that the suspension of the IRM could be a ploy to pass the blame on the senators for PhilHealth鈥檚 failure to make payments.
鈥淚鈥檓 sure that if the hospitals would ask them why they have not received [their payments], the PhilHealth officials would tell them that it was because the senators wanted to suspend [the IRM distribution],鈥� Lacson told the Inquirer.
鈥淭hey already did that 鈥榓ppeal to emotion鈥� when they said that senators do not care about the dialysis patients after we asked them why funds for COVID-19 were given to dialysis centers. They are skirting the issue by portraying us as heartless,鈥� he said.
He said the suspension of the IRM would be 鈥渦nfair to hospitals that are really qualified鈥� to get the IRM funds.
Lacson surmised that PhilHealth officials agreed to halt cash advances as they had already provided funds to a select group of health facilities, including maternity clinics and dialysis centers.
Like Lacson, Sen. Joel Villanueva lamented that individuals who needed financial assistance might be unfairly affected by the suspension of the IRM and this could lead to the closure of some hospitals.
Panfilo Lacson 鈥擲ENATE PRIB
Limited options
If that happens, more workers would end up jobless, he said.
鈥淥ur sick will have more limited options to seek treatment especially in this time of pandemic,鈥� Villanueva said.
But he said 鈥渋t is clear to us鈥� that PhilHealth favored several hospitals by abusing the reimbursement mechanism.
Lacson and several other senators believe that IRM funds had been arbitrarily given to selected hospitals.
PhilHealth corporate counsel Roberto Labe Jr. said that was not true.
Lacson also doubted whether the remaining IRM fund was still intact, citing the disclosure by the Commission on Audit (COA) during the Senate probe that of the P14.9 billion already disbursed, only P1 billion had been accounted for.
Senate Majority Leader Juan Miguel Zubiri, who also exposed other irregular schemes in PhilHealth, said the moratorium on the IRM releases was a 鈥済ood first step toward transparency.鈥�
鈥淭his will allow COA and the Office of the Ombudsman to monitor and account for the earlier releases of the funds,鈥� Zubiri said in a Viber message.
He said the release of large amounts of money from the IRM 鈥渨ithout a clear disbursement program or budget request, especially to private companies, is highly irregular and prone to all sorts of corruption.鈥�
This should be stopped until a 鈥減roper accountability system鈥� is adopted, Zubiri said.