By Ben Rosario  State auditors rebuked the management of the Philippine Heart Center as they noted inconsistencies in the charging of mark up cost for consigned items used by patients, mostly suffering from serious cardiovascular illnesses. The 2018 annual audit report on the PHC that was released last week also revealed that the “No Balance Billing Program” for patients confined for more than 45 days resulted in additional expenses because of the failure of the specialty hospital to strictly implement the program in accordance with a Philhealth circular. COA likewise said that the PHC failed to impose adequate control measures in the “requisitions, storage, handling and inventory of supplies and materials” at its Operating Room (OR), thus exposing the items to risk of loss and misuse. These findings summed up the compliance issues raised by state audit examiners in the audit report. Auditors said the inconsistencies in the compliance to the Guidelines on Charging for Consigned Items have resulted in “inaccurate charges to patients.” Under the guidelines, PHC can prescribe mark up rate of 30 percent of the contract price of an item costing P20,001 and above while a special discount of 12 percent for such items may be granted to patients not covered by government-mandated discounts. For consigned items priced at P20,000 and below, the PHC’s markups may vary from 43 percent, 55 percent, 65 percent and 75 percent. As gathered from available records, COA noted overcharging of consigned items by as high as 75 percent for certain medical items yet undercharging of 65 were also imposed for other materials costing P20,001 and above. Auditors were also baffled by financial records indicating no mark up charged from patients. Among those cited was the use of Dual ICD Package Fortify Assura DF$ acquired by PHC at P74,500 but sold to a patient at the same price, thus, denying government a profit of P224,250 or 30 percent of the PHC purchase cost. “The PHCs implementation of the NO Balance Billing (NBB) Program for patients’ confinement of more than 45 days was not in accordance with Philhealth Circular NO. 2017-0017, thereby increasing PHC’s expenses beyond the limit of confinement allowed,” COA reported. Under the NBB program, poor patients may avail of the benefits so long as their confinement do not reach beyond 45 days. Auditors disclosed that 23 patients, whose confinement cost the PHC P23.59 million, stayed beyond the 45 days limit but have not been charged the extended days of confinement. Instead, the expenses were charged to PHC funds. COA also directed the PHC management to impose strict measures at the OR Main Stockroom and Dispensing Area to prevent shortages and risk of loss of medical supplies and materials.