PhilHealth 'needs overhaul' after COA flags P14.97-B advance to hospitals in 2020: solon

ABS-CBN News

Posted at Dec 06 2021 10:58 PM

The facade of the PhilHealth Head Office in Pasig City on September 5, 2020. George Calvelo, ABS-CBN News/File
The facade of the PhilHealth Head Office in Pasig City on September 5, 2020. George Calvelo, ABS-CBN News/File

MANILA — A lawmaker on Monday raised the alarm on the Philippine Health Insurance Corporation after the Commission on Audit bared that the state health insurer released P14.97 billion to hospitals last year under the Interim Reimbursement Mechanism (IRM) supposedly without legal basis.

Marikina 2nd District Party-list Rep. Stella Quimbo, in a statement, noted that the state audit body discovered PhilHealth released the funds to 711 healthcare institutions "without completing the rendering of services."

"This is in clear violation of the Government Auditing Code of the Philippines which requires the President’s approval for advance payments," she said, echoing the COA's position.

Quimbo, citing COA's report, said PhilHealth also released IRM funds worth P10.65 billion to 488 hospitals, past above the state health insurer's own rules and regulations.

"This resulted in excessive releases in the range of P81.5 million to P2.2 billion, which could have gone to other qualified hospitals to provide immediate care to their patients," she said.

Quimbo slammed the PhilHealth's alleged illegal expenditure, stressing that "strong intervention in the institution is a pressing need."

"PhilHealth’s financial mismanagement blatantly disregards the law. It is an injustice to PhilHealth members who regularly make premium contributions and patients who do not receive PhilHealth payments they need for their urgent health services," she said.

Quimbo, who last year flagged the state insure for losing as much as P15.4 billion from its coffers from 2014 to 2018 over schemes of falsifying pneumonia claims, said the COA's finding's report confirmed her office's findings "that this unbridled spending not only deprived Filipinos of urgent health care but also caused significant financial damage to an important national government agency."

"If we are to have an effective and responsive national health insurance system, PhilHealth must immediately overhaul its operations. That said, I urge the House to take up my proposed measure, the Social Health Insurance Crisis Act which I filed last August 19, 2020. This bill will ensure a more effective management in PhilHealth," she said.

The state health insurer has been embroiled in multiple controversies involving graft and corruption.

PhilHealth is among "graft-prone" government agencies in the country, the justice department said last September.

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