Duque orders PhilHealth to look into ‘loopholes’ in advance hospital payments system

Kristine Sabillo, ABS-CBN News

Posted at Aug 19 2020 06:45 PM

MANILA — Health Secretary Francisco Duque III on Wednesday said he has ordered the Philippine Health Insurance Corp (PhilHealth) to review the controversial interim reimbursement mechanism- the system of advance payments to hospitals during emergencies- following corruption allegations and concerns raised by legislators.

“Confusion has arisen from the circulars issued in the haste to readily provide the needed financial support to the Health Care Institutions (HCIs) during the pandemic. Let us look into any loopholes and clarify procedures to ensure that the issues raised are responded to,” Duque said in a statement released by the Department of Health.

Duque is chairman of the PhilHealth Board of Directors.

The DOH explained that the IRM is a pre-payment mechanism for health institutions “affected by fortuitous events and emergencies.” It added that the IRM was used in previous calamities such as Tropical Storm Ondoy in 2009, Supertyphoon Yolanda in 2013, the Marawi siege in 2017 and the Taal volcano eruption earlier this year.

The IRM made headlines after a whistleblower accused PhilHealth officials of pocketing P15 billion in funds through fraudulent schemes.

Sen. Panfilo Lacson earlier questioned the use of the fund for dialysis centers and maternity clinics but Duque insisted that they are also covered.

In his statement, Duque said, "The effects of the pandemic, while falling heavily on COVID-19 referral facilities, have affected the entire health system. These include cancer and dialysis treatment centers, maternity clinics and other similar facilities that provide care for patients while the regular hospitals are busy addressing COVID patients. For this reason, they should also be assisted by PhilHealth.”

Duque also asked PhilHealth to ensure that their system in identifying IRM recipients is systematic and “meritorious, in the light of allegations of palakasan made before the legislative bodies.”

He said despite the suspension of the IRM, Filipinos can still avail of PhilHealth benefits, including those for COVID-19.

Senate Minority Leader Franklin Drilon earlier said at a Senate hearing on alleged PhilHealth corruption that its hospital reimbursements were selective and "based on vengeance rather than need."