House to dissect PhilHealth P14-B advanced payments
The House Committee on Public Accounts will sift through at least P14 billion in advanced payments made by the Philippine Health Insurance Corp. (PhilHealth) to hospitals handling coronavirus disease 2019 (Covid-19) cases for signs of fraud.
“We have already asked PhilHealth to submit all supporting documents,” said the committee chairman, Rep. Mike Defensor, on Friday.
The state health insurer, which has come under scrutiny for supposed systemic corruption, is being investigated by the House.
PhilHealth provides advanced payments drawn from its Interim Reimbursement Mechanism Fund (IRM) to health care institutions (HCIs) treating Covid-19 patients. As of May, PhilHealth has released a total of P13.8 billion to 599 HCIs across the country.
The amount was part of the P30 billion allocated by PhilHealth for Covid-19 cases.
Defensor said of the released IRM, only P1 billion has been liquidated or supported with documents by hospitals and other healthcare facilities that received advances.
“We hope to get by next week the supporting papers, which should indicate the amounts advanced, the recipient-hospitals, amounts liquidated, number and classification of new coronavirus disease cases, number and names of patients, medicines given, and the treatment patients received,” he said.
He warned hospitals to be careful in liquidating the advanced payments. PhilHealth has set package rates for Covid-19 cases: P43,997 for mild pneumonia; P143,267 for moderate pneumonia; P333,519 for severe pneumonia; and P786,384 for critical pneumonia/coronavirus disease.
Defensor said health facilities must not make a full reimbursement or payment claim for a “package rate” of almost P44,000 for mild pneumonia if a patient was only treated for cough, colds and fever.
“Theoretically, a hospital can do that, and it happened in many cases in the past. But now we are watching,” he said.
Defensor said the Commission on Audit found instances of overpayment in at least 20 percent in the case of package rates.
He said “20 percent of P14 billion is P2.8 billion. That is the potential loss from the amount PhilHealth advanced to hospitals. We will watch out for any sign of overpayment or excess payment or claims in the documents we have asked from PhilHealth.”
On Thursday, PhilHealth announced it was suspending the IRM while it reviews the implementation of IRM and as it resolves issues raised in the House probe.
Deputy Minority Leader and Bayan Muna party-list Rep. Carlos Isagani Zarate, one of the authors of House Resolution 1074 that calls for the PhilHealth probe, demanded the preventive suspension of agency’s top officials starting on Monday.
“To prevent, to preclude tampering of related documents — not only on the issue of IRM and IT programs, but on all anomalous transactions there — we call for the temporary suspension of officials named to have been involved in anomalous transactions),” Zarate said in an online press briefing on Friday.
ACT-CIS party-list Rep. Jocelyn Tulfo wants the inquiry to cover Health Secretary Francisco Duque 3rd as chairman of the PhilHealth board.
“We do not merely want him out of PhilHealth. He should be investigated by Congress and the Ombudsman for the anomalies that have plagued PhilHealth long before the Covid-19 pandemic,” Tulfo said.
“If he is incapable of making a simple statement regarding the status of the corporation he is in charge of, then clearly he is no longer fit to act as PhilHealth chairman during this time where a strong leadership is needed to ensure its financial viability,” she said, referring to Duque.
As the controversy surrounding it deepened, PhilHealth assured it would continue health insurance payments to its members.
In a statement, PhilHealth President and Chief Executive Officer Ricardo Morales allayed fears that the insurer’s offices nationwide will stay remain open for transactions while implementing health and safety
PhilHealth also called on the Presidential Anti-Corruption Commission (PACC) to release the supposed list of employees allegedly involved in corruption.
It said the statement of PACC Commissioner Greco Belgica was a “sweeping generalization” and unfair to most of its employees.
The state insurer has vowed to cooperate with the investigations and will not hesitate to punish those who will be found guilty.
Also on Friday, the Alliance of Health Workers (AHW) held a lunch break online protest to express their “outrage of the heinous corruption and misappropriation of PhilHealth’s funds.”
In a statement, the group said health workers are upset because during their fight against the pandemic, the government only allotted limited funds for their needs, while the bulk of the funds are stolen by ranking PhilHealth and government officials.
“The miniscule budget in the public hospitals and health facilities nationwide greatly affect the public health care system especially now that there is pandemic. The continuous cut on health budget shows that health is the least priority of the government.” the group said.
It added that 66 public hospitals have raised fees for such services as laboratory services, medicines, supplies and room rates.
Robert Mendoza, AHW president, said billions of pesos were “squandered” by PhilHealth officials, some private hospital owners and health professionals, as well as some politicians.
The group claimed that the Universal Health Care Act will transform the public health care system into a “giant business” where marginalized patients will be deprived of free treatment from public hospitals and health facilities.
With reports from RED MENDOZA
Source: TheManila Times
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