PHAPI hospitals plan for ‘PhilHealth holiday’ suspended

ABS-CBN News

Posted at Dec 29 2021 08:29 AM | Updated as of Dec 29 2021 04:38 PM

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MANILA -- The plan for a so-called "PhilHealth holiday" has been suspended, Dr. Jose de Grano, president of the Private Hospitals Association Philippines (PHAPI), announced on Wednesday.

De Grano cited citizens' and patient groups' request to be "informed well and advised on what to do during the holiday."

The PHAPI on Monday said that it was encouraging its members to not accept PhilHealth deductions for their services on January 1-5, 2022, in support of seven Iloilo hospitals who severed ties with the state insurer over P895 million in unpaid claims. 

"We suspended the implementation of our PhilHealth holiday because of the clamor of a lot of our patients and concerned groups who are very dependent on PhilHealth benefits," De Grano told ANC.

"A lot of patients are really dependent on PhilHealth, you know, cancer patients who are undergoing chemotherapy, those patients who are try to avail of the Z-Package, of course, and some dialysis patients, and a lot. Of course, all our patients have PhilHealth benefits because [of] the universal health care," he explained.

De Grano said that hospitals in Iloilo are objecting to a provision in the "Debit Credit Payment Mechanism" (DCPM) being proposed by PhilHealth.

"There is one provision there that says that Philhealth reserves its right to suspend these payments under DCPM for any other reason deemed relevant by Philhealth. That means for any other reason, they can just stop it."

"And that’s--I think, most of hospitals will think that’s something like more one-sided, very one-sided and lopsided agreement."

PhilHealth had said DCPM "provides hospitals sufficient cash flow to continue providing the sick with quality health care during the pandemic."

The doctor said the impasse between Iloilo private hospitals and the state health insurer is "unfortunate."

He said, however, that they may still declare a "PhilHealth holiday" if PHAPI and the state insurer fail to engage in meaningful discussion.

"Kung hindi kami magkaroon ng malinaw na ugnayan ulit after January, ilo-launch uli naming itong PhilHealth Holiday,” he said.

De Grano said only PhilHealth’s settlement of all its obligations to private hospitals can make the group abandon their plan to declare a "PhilHealth holiday.”

He said the state insurer already owes them an “average of P10 billion” to date.

PhilHealth, he added, should also amend its “one-sided” “Performance Commitment” with private hospitals, which has been extended by the agency for another 30 days.

“Bayaran nila (PhilHealth) yung mga pagkakautang nila sa amin, at saka itong PhilHealth holiday, gagawin namin yan during the time na tapos na yung kontrata, yung tinatawag na 
'Performance Commitment”… hindi patas yung kasunduan."

"So ire-request namin na gawin itong joint Performance Commitment undertaking na patas, at hindi nakakalamang in favor of PhilHealth,” he said.

“Yung pagbabayad, bukod sa good claims at in process claims, hihingin namin of course na yung mga denied claim na wala namang masyadong eksplanasyon kung bakit nila dinenay, bayaran agad nila."

"Kasi kung wala namang violation na nagawa at dinenay nila, nagtataka kami kung bakit… hindi naman nila isinama yun sa tinatawag nilang DCPM,” he added.

De Grano has also advised their member-hospitals not to immediately sign the DCPM.

“Basahin nilang mabuti yung ‘Terms and Condition.’ Baka akala nila eh bibigyan lang sila ng pera na ganun kalaki, kung totoo man yun. May mga nakalakip po yun na provision na dapat basahin nila, kasi minsan matatali sila sa alanganin kung sakaling magkakaroon sila ng pagkakamali,” De Grano pointed out.

“Ngayon lang po siguro tayo makakakita na kung sino yung may utang, siya yung nagbibigay ng kundisyon kung magkano ang ibabayad sa'yo, at kung kalian ko ibibigay sa yo, at kung papano ko ibibigay sa yo….pwede pa rin nilang bawiin,” he stressed.

A Palace official, however, said that the best way to solve the funding problem of hospitals would be to participate in the DCPM.

"Ang magiging biktima dito would be the mga pasyente. Kung wala pong pondo, wala pong pera ang hospitals, mahihirapan po silang magserbisyo sa taong-bayan, sa kanilang mga pasyente," Cabinet Secretary Karlo Nograles said of the proposed PhilHealth holiday. 

(The victims here would be the patients. If hospitals lack funds, money, it will be difficult for them to serve the public, their patients.)

"The best way is to participate in DCPM 3 para sa ganoon magkaroon ng fresh funds ang hospitals (so that hospitals will bet fresh funds)," he said in a press briefing.

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--with reports from Sherrie Ann Torres and Jamaine Punzalan, ABS-CBN News