PhilHealth ordered to pay private hospitals, probe anomalous claims

Published August 23, 2021, 3:06 PM

by Argyll Cyrus Geducos

Presidential Spokesman Harry Roque told the Philippine Health Insurance Corporation (PhilHealth) to immediately pay private hospitals, saying the government cannot afford to derail the implementation of the Universal Health Care (UHC) law amid the coronavirus (COVID-19) pandemic.

Presidential Spokesman Harry Roque and PhilHealth Chief Dante Gierran (Malacañang, Presidential Task Force on Media Security photos)

The Palace official made the statement after hospitals and physicians groups said they were disengaging from PhilHealth after it issued a circular suspending the payment of hospital claims to control fraud.

In his press briefing on Monday, August 23, a visibly emotional Roque said he will not allow the warning of health groups to materialize because it would affect the country’s healthcare system during the pandemic.

“Itong banta nila na sila ay magtitigil na magbigay serbisyo at mag-disengage sa PhilHealth (Their threat to stop providing services and to disengage from PhilHealth), that has the potential of derailing the Universal Health Care,” Roque said.

“Hindi kayang ma-implement ang Universal Health Care na pang-gobyernong ospital lang ang magbibigay ng serbisyo, lalong-lalo na sa panahon ng pandemya (We cannot implement the UHC law with just the public hospitals, especially with the ongoing pandemic),” he added.

Roque, the primary author of the UHC Law in the 17th Congress, urged PhilHealth to pay private hospitals, reminding them of their duty as the sole purchaser of all medical goods and services.

“Magbayad kayo ng dapat bayaran (Pay what you have to pay),” he addressed the state insurer.

“Kinakailangan magkaroon ng kooperasyon. Ang PhilHealth, magbayad nang mas mabilis (There has to be cooperation. PhilHealth needs to pay them faster),” he added.

Meanwhile, Roque said there were still probably anomalous claims but PhilHealth only needed to investigate them and not to suspend the payment of claims, saying lack of funds cannot be an excuse.

“I will be the first to tell you, hinding-hindi po mauubos ang pondo ng PhilHealth (PhilHealth will never run out of funds),” he said.

The Palace official likewise asked PhilHealth chief Dante Gierran why there was only one PhilHealth official removed over anomalous claims, noting that it was even by way of resignation.

“Ang ibig mo bang sabihin, lahat ng mga anomalya sa nakalipas, eh naririyan pa rin ang lahat ng mga taong responsable pa diyan at ni isang tao sa PhilHealth hindi dapat sibakin (Do you mean that of all the people involved in previous anomalies are still in PhilHealth and none of your people had to be sacked)?” Roque addressed Gierran.

“Hindi po kapanipaniwala ‘yan (That’s unbelievable),” he added.

President Duterte named Gierran, former director of the National Bureau of Investigation, as PhilHealth chief in August last year, replacing Ricardo Morales.