Poe calls for 'middle ground' between PhilHealth, hospital groups on pending reimbursements

Published August 23, 2021, 10:31 AM

by Vanne Elaine Terrazola

Senator Grace Poe on Monday, August 23, appealed to the Philippine Health Insurance Corporation (PhilHealth) to reconsider its circular suspending its payments over reports of fraudulent claims.


“PhilHealth must not resort to a sweeping mechanism that could further delay the settlement of legitimate obligations,” Poe said in a statement.

The PhilHealth, thru its Circular No. 2021-0013, suspended its payment of claims for 120 days. PhilHealth president and chief executive officer (CEO) Dante Gierran said this was a “preventive measure” against the loss and wastage of funds due to fraudulent and unethical acts, as well as abuse.

But hospitals associations slammed the move as “arbitrary and unjust” and were reported as already considering to disengage from the state health insurer.

“We urge PhilHealth and hospital groups to reach a middle ground to straighten out disagreements on the payments of claims,” Poe appealed.

“The well-being of PhilHealth members is on the line if the standoff will not be resolved,” she pointed out.

“As it is, a number of hospitals are reeling from financial distress due to unpaid claims, putting in peril their capacity to provide service to Filipinos covered by the state health insurance. The delays or non-payment of claims are also sapping the resources of hospitals to pay their medical frontliners,” she added.

The PhilHealth, she said, should already know its responsibilities.

“Hindi dapat maging rason ang katiwalian ng ilan sa pagdurusa ng mas nakakarami (The majority should not be made to suffer because of the corruption by a few),” Poe appealed.

Hospital groups previously lamented that they are forced to use their savings and loan from banks due to “severe financial distress”. They also lamented about the “aribtrary” denial of their claims.