Lacson questions Philhealth’s grant of funds to hospitals for COVID-19 reimbursement claims

Published August 11, 2020, 2:54 PM

by Mario Casayuran

Senator Panfilo M. Lacson questioned on Tuesday the decision of the Philippine Health Insurance Corporation (PhilHealth) to adopt an Interim Reimbursement Mechanism (IRM) with a value of billions of pesos for hospitals still to be hit by the coronavirus disease (COVID-19) in January.


Lacson inquired why the IRM was adopted by PhilHealth when the Department of Health (DOH) formally recognized only on January 30 the first case of COVID-19 to hit the country from a 39-year-old female Chinese from China.

President Duterte formally placed Metro Manila and other parts of the country under lockdown because of COVID-19 infections in mid-March.

Lacson stated in yesterday’s public hearing by the Senate Committee of the Whole that PhilHealth was prescient in adopting the IRM mode.

There are allegations of  widespread corruption at PhilHealth  where some P15 billion had reportedly been pocketed by corrupt officials and insiders.

PhilHealth officials claimed that funds not spent for COVID-19 patients would be kept by hospitals for non-COVID cases but senators did not buy this, saying PhilHealth is an insurer and that payments should only be for specific cases.

They also said that the IRM was adopted to prepare hospitals to respond to COVID-19.

Lawyer Roberto Labe Jr., PhilHealth legal counsel, cited the top 10 hospitals that were recipient of IRM funds.

The first was Southern Philippines Medical Center in Cebu that was given P326 million.

Second was the University of the Philippines (UP) Philippine General Hospital (PGH) that received P263 million.

Third was Davao Regional Medical Center. It was given P209 million.

Other recipients of large amounts from PhilHealth IRM scheme were the following hospitals:  Vicente Sotto Memorial Medical Center in Cebu City, P204 million;  Jose B. Lingad Memorial Regional Hospital, P201 million; National Kidney and Transplant Institute in Quezon City P179 million; Baguio General Hospital and Medical Center; P165 million; Northern Mindanao Medical Center, P150.2 million; Quirino Memorial Medical Center in Quezon City, P150 million;  and Eastern Visayas Regional Medical Center in Tacloban City P146.2 million.

Alejandro Cabading, PhilHealth Board member, claimed that there is a case of influence peddling in the disbursement of IRM funds to hospitals and health facilities.

Augustus de Villa said he recently resigned as PhilHealth  Executive Vice President for Operations because ‘’it is the honorable thing to do’’ as he could not take anymore the numerous allegations surrounding PhilHealth.

These allegations of fraud or questionable decisions surround the IRM, COVID testing rate, unresolved administrative cases, flawed internal processes and old case rates, he said.