Gov't says it has funds for PhilHealth's unpaid claims as hospitals threaten to cut ties


Posted at Nov 02 2021 06:42 PM

Workers paint the walls of a hospital in Quezon City on Aug. 15, 2019. ABS-CBN News/File
Workers paint the walls of a hospital in Quezon City on Aug. 15, 2019. ABS-CBN News/File



MANILA — The government said Tuesday it has funds to settle PhilHealth's unpaid claims, which have prompted some private hospitals to consider cutting ties with the medical insurer. 

The Private Hospitals Association of the Philippines Inc (PHAPI) last week said some of its members might not renew their accreditation with PhilHealth because most claims for the treatment of COVID-19 patients last year remain unpaid.
Palace spokesman Harry Roque noted PhilHealth sources funds from premiums, taxes, the budget department's appropriation, and the revenues of the game regulator and the PCSO. 

"Sinasabi ko po sa inyo, hindi magkukulang ang pondo ng gobyerno para rito," Roque said in a press briefing. 

(I am telling you, government funds for this are not lacking.) 

The healthcare system will suffer a capacity shortage without private hospitals, which account for about 70 percent of medical services, Roque said. 

"Nanawagan po ako, uulitin ko na lang po iyong request ni Presidente Duterte kay [PhilHealth] president [Dante] Gierran, bayaran at bayaran iyan," said the official. 

(I am calling on PhilHealth President Dante Gierran. I will repeat the request of President Duterte to president Gierran, keep paying that.) 

Video courtesy of PTV 


Some private hospitals, including in Metro Manila, will release in November a position paper on whether or not they would cut ties with PhilHealth, said PHAPI president Dr. Jose Rene De Grano. 

"Karamihan po diyan ay siguro hindi na magre-renew ng kanilang PhilHealth by next year dahil po sa naranasan nila na wala pong kongkretong solusyon na ibinibigay ang PhilHealth sa nakaraang mga 2 o 3 buwan," he told TeleRadyo.

(Many of them may not renew with PhilHealth next year because of what they have experienced. There is no concrete solution from PhilHealth for the last 2 or 3 months.)

De Grano in October said PhilHealth still owed at least P834 million to some private hospitals in General Santos, Iloilo and Northern Luzon. 

At a Senate hearing, PhilHealth admitted to delays in processing of claims for COVID-19 cases.

“We are so swarmed with increase of claims. Can you just imagine, in 2020, we have the average of daily claims of 31,000, and the average the number of claims now is 39,000. Ibig sabihin (Which means) that is job increase of 26 percent," Gierran had said.

PhilHealth also faced a manpower shortage, he added.

PhilHealth reimbursement delays make it harder for hospitals to retain their manpower. The government insurer should not cause the departure of health workers "especially at a time when the pull of foreign recruiters is strong," said Sen. Joel Villanueva.

"You can have hospital beds but without medical staff, those beds are reduced to pieces of furniture," he said in a statement. 

Villanueva said PhilHealth should aim for a "zero backlog goal" in settling reimbursement claims by the end of the year.

Sen. Risa Hontiveros meanwhile urged private hospitals to "remain committed to ensuring access to affordable healthcare."

The government, she added, "should explore options to provide crucial financial aid to hospitals at risk", given its limited capacity to provide hospital care. 

"The pandemic isn’t over yet and our current health system must be able to serve the needy, and not just those who are able to pay," she said in a separate statement. 

PhilHealth and PHAPI, in a meeting with Executive Secretary Salvador Medialdea on Tuesday, "committed to work together" over the issue, said Duterte's longtime aide Sen. Christopher Go.