Hospitals are now scrambling for funds to continue operating as the Philippine Health Insurance Corporation (PhilHealth) has yet to settle a "huge" amount of unpaid reimbursements for treating COVID-19 patients.
Dr. Jaime Almora, president of the Philippine Hospital Association (PHA), disclosed to senators on Wednesday, May 19, that the "huge amount of unpaid claims" are already causing "severe financial distress" for both government and private hospitals in the country.
"They have to dig into their savings and they have to borrow from the bank, some hospitals have called me already that they have to borrow from the bank for the operating budget," Almora said at the continuation of the Senate economic affairs committee's hearing on the impacts of the coronavirus pandemic to sectors and the government's interventions for them.
According to Almora, small hospitals are waiting for reimbursements worth at least P50 million, while bigger ones hope to collect P700 million to as much as P1.2 billion from the PhilHealth. Some of the unpaid claims date back since the pandemic started in March last year, he said.
The state health insurer only pays expenses for non-COVID-19 patients, which he said have already decreased by 50 to 70 percent of their usual number.
"We are not given reason why," Almora told the senators.
"There was already decrease in the income of hospitals from the non-COVID . And they are treating COVID-19 cases that are not being paid," he lamented.
The unpaid reimbursments, he noted, do not include the professional fees for doctors. The PhilHealth has also yet to settle these.
"So here are doctors working for COVID-19 patients but they are not being paid, except for hospitals that accept co-payment," referring to the amounts paid in excess of the PhilHealth's benefit packages.
This is also not new as lawmakers, during the Senate Committee of the Whole's investigation on the alleged irregularities in the PhilHealth last year, reported complaints about the government-owned corporation's delayed payments to doctors.
Almora also noted that actual expenses incurred by COVID-19 patients exceed the amounts covered by the PhilHealth.
He said the PHA met last April 5 PhilHealth President and Chief Executive Officer Dante Gierran, who was "sympathetic and accommodating" of their request.
"And he promised that they are going to pay," the PHA president said.
The PhilHealth then came up with the Debit-Credit Payment Mechanism to settle 60 percent of the hospitals' unpaid claims, but Almora said hospitals were hesitant to avail of the program.
"The hospitals are suprised why they have to apply and why they have to sign an undertaking. It is like a borrower cannot pay and asking the one lending the money that he will be the one to do the undertaking...Kaya 'yong maraming hospital, nagulat sila, so 'di sila nag-apply (That's why several hospitals did not apply)," Almora said.
While he believed Gierran was "sincere" in his commitment to pay for their claims, some hospitals that did apply only received "small" payments. He also claimed that regional PhilHealth offices that are supposed to release their reimbursements are "withholding the payment for some reason that we don't understand."
Senators Imee Marcos and Francis "Kiko" Pangilinan agreed that it was "unacceptable" for the PhilHealth to leave the hospitals operating without paying it debts.
"At this point parang 'wala kaming pakialam sa inyo, magtiis kayo' ang dating sa atin dito (it seems to us that the PhilHealth was telling you: 'We don't care about you and you should deal with it)...You are the fronliners, and yet this is how your are treated by the government in terms of government support, in terms of funding. This is totally unacceptable," Pangilinan said.
"It's already May, 2021, you are being asked to feed the multitides with five loaves of bread and two fishes. This is completely unacceptable," he added.
Marcos said the PhilHealth will be asked to explain about the delay in its reimbursements to hospitals in the panel's next hearing.