MANILA - Sen. Pia Cayetano on Tuesday asked the Philippine Health Insurance Corp (PhilHealth) to explain the release of funds in areas with low COVID-19 cases, saying it was a violation of a policy that mandates the health insurance firm to boost funding in hospitals tending to coronavirus patients.
Under PhilHealth's Circular No. 2020-0007, the agency shall provide "special privileges" to hospitals in areas hit by "fortuitous" events.
"On the part of PhilHealth, it was erroneous for you to release your funds. You're supposed to give it as a fortuitous event," she said, noting that money was downloaded in several regions that were not grappling with the pandemic.
"Hindi pa nangyayari 'yung event (COVID-19 case), nagbigay na kayo [ng pondo]. Tapos, on top of that, may mga [ospital na may COVID-19] na hindi pa nabigyan," she said.
(COVID-19 cases were not yet recorded in the areas where you disbursed the funds. But on top of that, there are hospitals with many COVID-19 cases that did not receive money.)
PhilHealth president Ricardo Morales justified the disbursement, saying the insurance firm wanted to make sure that regional facilities have enough funding should the disease spill over to rural areas.
"Gusto ho natin unahan yung spread ng COVID, kaya kahit yung areas like Bicol or Region 8 na mababa pa yung COVID, nakatanggap po sila," he said, without giving specific amounts.
(We wanted to be ahead of the spread of COVID, that's why areas like Bicol or Region 8 where COVID cases are low have already received funding.)
"It's too early to say na hindi kakailanganin 'yan sa pagdating ng panahon," he said.
(It's too early to say that they won't need the money.)
But Cayetano refuted the PhilHealth chief, saying that the agency should have crafted a separate policy for areas that were not bearing the brunt of the COVID-19 crisis.
"I agree, there are other health needs, but not through this mechanism," the senator said.
"Does that not require investigation because this circular is very specific for fortuitous events?" she said.
Morales said some hospitals may have received funding ahead of others due to their efficient liquidation system.
"There are some areas that are more administratively efficient than others. So yun siguro ang reason bakit may nakakatanggap, bakit may hindi nakakatanggap," he said.
Cayetano said "there is no logic" to the PhilHealth chief's explanation.
"If we release it for other purposes, then it is contrary to the circular," she said.
"It is not a matter of being efficient because it is not within the mandate [of PhilHealth] to release those funds for those purposes."
PhilHealth earlier said it has released P14.9 billion of the P27 billion fund the board approved for reimbursements for unforeseen events or emergencies like COVID-19.
The board "will see" if it can issue a new resolution to address the issue, Morales said.
Aside from the prioritization of non-COVID-19 hospitals, the Senate also found that PhilHealth has released COVID-19 funding to dialysis centers and maternity clinics.
The Senate will hold another investigation on the alleged irregularities in PhilHealth next week.