PhilHealth set to receive P34.99-B in 2023 to fund Universal Healthcare Act

Gillan Ropero, ABS-CBN News

Posted at May 30 2022 05:04 PM

MANILA - State insurer PhilHealth is set to receive some P34.99 billion in 2023 to improve its benefit packages under the Universal Healthcare Act.

The development comes as the Philippine Charity Sweepstakes Office (PCSO) and the Philippine Amusement and Gaming Corporation (PAGCOR) on Monday signed a joint circular on the guidelines for the operationalization of funds for the Universal Healthcare Law. 

Under the law, 50 percent of government's share from the income of PAGCOR and 40 percent of PCSO funds will be transferred to the Bureau of Treasury and then to PhilHealth via the General Appropriations Act to improve its benefit packages.

From 2019 until 2021, the PCSO and PAGCOR has accumulated some P1.66 billion and P33.332 billion, respectively, to fund the UHC Law.

"Our fund pool for PhilHealth's individual-based services is ready and available and shall be released promptly consistent with the DOF (Department of Finance), DBM (Department of Budget and Management), DOH (Department of Health), PAGCOR, PSCO, PhilHealth UHC remittance guidelines," PCSO chairman Anselmo Pinili said in a press briefing.

"Your P20 not a wager, but a contribution for health programs of government. Sa PCSO ang bawat taya natin ay para sa kawang-gawa (At PCSO, your bet is for charity)."

PhilHealth said the following were among benefit packages that will be improved:

  • select medical and surgical procedures
  • expansion of case rates for hemodialysis up to 156 sessions
  • enhancement Z benefit packages for selected orthopedic implants
  • post kidney transplant
  • breast cancer, prostate cancer, cervical cancer
  • open heart surgery for children (ventricular septal defect and tetralogy of fallout)
  • and physical medicine and rehabilitation

The law's full implementation will "take years," according to PhilHealth spokesperson Shirley Domingo.

"This is an omnibus law related to health reforms. There are so many components we cannot immediately implement at once. We were given 6 years to transition to the full implementation of the law," said Health Undersecretary Mario Villaverde.

"Now we are on the 3rd year, we hope in the next 3 years magagawa natin lahat ng provisions na nasasapaloob ng batas (we will be able to enforce all provisions under the law."

Some provisions, such as the automatic membership of all Filipinos into PhilHealth, have already been implemented, Domingo said.

When asked about PhiiHealth's delayed reimbursements to private hospitals, Domingo said the state insurer has been releasing funds through regular processing and its debit-credit payment mechanism.

"We continue to do reconciliation meetings with them. We have expedited the release of reimbursements to them," she said.


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