Senators on Tuesday claimed that Philippine Health Insurance Corp. (PhilHealth) has yet to pay doctors their professional fees despite months of battling the COVID-19 pandemic.
During the resumption of the Senate Committee of the Whole's investigation on the irregularities in the PhilHealth, Senate President Vicente Sotto III said doctors have reached out to him and complained about the state insurer's delayed payments of their individual claims.
According to Sotto, the doctors last received their collectibles from PhilHealth in February, some were from claims they submitted to the agency in August, 2019.
"Naghahanap-buhay din po itong mga doctor, ang laki ng backlog ninyo (These doctors also have to earn a living, you have a huge backlog)," Sotto told PhilHealth officials.
Later in the hearing, Senator Francis Pangilinan also cited complaints not only on the delay, but the reduction of the doctors' professional fees.
Israel Pargas, PhilHealth senior vice president for health finance policy sector, explained to senators that the payment of professional fees has been included in the reimbursements released to hospitals and health care facilities. And the hospitals should pay the doctors in return.
"The case rates includes the professional fees so it is the hospitals who are to provide the professional fees to the doctors. As per policy, once the hospitals have received the payment of their claims, they are given one month to provide it to the doctors," Pargas explained.
He also cited the doctor can access the PhilHealth portal where they can check if their claims have already been paid or not. "The doctors can actually check on these," the PhilHealth official said.
Questioned by Sotto, Pargas however acknowledged that some hospitals have yet to receive their reimbursements and, hence, have yet to pay their doctors.
"Iyon po ang pina-process natin and kung meron pong mga ospital na hindi pa po nababayaran, then technically po 'yong sa mga doctor hindi pa po natin nababayaran. (That is what we are processing right now and if hospitals are not yet paid, then technically the payments to the doctors have yet to be issued to them)," Pargas admitted.
With the PhilHealth official's answer, Pangilinan Iamented the plight of medical frontliners and compared it to the alleged favoritism of the state insurer toward non-COVID-19 health care facilities in its reimbursements.
"Sila ang nasa frontlines, tinataya ang buhay nila, tapos, dahil delayed yung pagrelease sa ospital, delayed din yung pagrelease sa mga doctor. (They are in the frontlines, risking their lives, and yet, because of the delayed release to hospitals, the payments to them have also been delayed). The least we can do is support our frontliners, put our money where our mouth is, in the PhilHealth," the opposition senator pointed out.
The Senate is investigating, among other, the questionable advanced payments given by the PhilHealth to dialysis center and maternity care facilities that do not cater to COVID-19 patients.
Health Secretary Francisco Duque III, in the hearing, agreed that such a move was "illegal" and assured to "rectify" the errors.