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Senators welcome suspension of PhilHealth's reimbursement scheme; say fraud clean-up essential to improving COVID-19 response

Published Aug 14, 2020 03:25 pm

Senate Majority Leader Juan Miguel Zubiri on Friday welcomed the Philippine Health Insurance Corporation's (PhilHealth) decision to suspend its Internal Reimbursement Mechanism (IRM) amid claims of irregularities.

Sen. Juan Miguel Zubiri (Senate of the Philippines / FILE PHOTO / MANILA BULLETIN)

"The suspension of the IRM is a good first step towards transparency and I welcome that move. This will allow the COA (Commission on Audit) and the Office of the Ombudsman to monitor and account for the earlier releases of the funds," Zubiri told reporters when asked to comment on the development.

The PhilHealth announced Thursday that it will put on hold its advanced payments to hospitals to review its implementation and "resolve issues arising from congressional inquiries".

Lawmakers have criticized the state insurer's implementation of the IRM for its alleged favoritism to select health care facilities. The Commission on Audit also flagged the lack of liquidation for most of its P14.97-billion IRM releases.

"This mechanism of releasing large amounts of money to health care institutions without a clear disbursement program or budget request especially to private companies is highly irregular and prone to all sorts of corruption schemes," Zubiri said.

"This system should be stopped until a proper accountability system is set in place."

Zubiri said the IRM funds could also be used to strengthen the country's public health care system and modernizing government hospitals to compete with private facilities.

"That is a better way of utilizing these public funds," he proposed.

Meanwhile, Senator Joel Villanueva pointed out the importance of addressing the problems of fraud in the PhilHealth amid the country's battle against the COVID-19 pandemic.

“Mahalaga po talaga na matunton ang ugat ng problema sa PhilHealth dahil tuwing may nawawalang pondo, nababawasan ang kakayahan ng ating gobyerno na gastusan ang mga pangangailangan ng ating mga kababayan, tulad na lang po ng pagpapatupad ng regular, random testing sa mga lugar-paggawa (It is crucial to get to bottom of the problem in the PhilHealth because every time funds are loss, our government's capacity to finance the needs of our people are affected, like the implementation of the a regular, random testing in workplaces),” Villanueva said in a separate statement.

In reiterating his appeal, the chairman of the Senate labor committee said the cost of such testing could have been easily shouldered by PhilHealth, but corruption issues contribute to the depletion of its funds.

"Inuulit po natin na ang pagbubukas sa ekonomiya at pagpapatigil sa mga pagsasara o tanggalan sa mga kumpanya ay nakasalalay sa pagkontrol sa COVID-19 (We repeat that the resumption of our economy or the prevention of the shutdown and retrenchment in companies depend on the control and management of the COVID-19)."

"Kaya ang pagpapatupad ng mandatory regular, random testing sa mga workplace ay napakahalaga dahil dito madaling kumalat ang COVID-19 (That is why the mandatory regular testing in workplaces is important to because transmission of disease is prevalent in these places)," he pointed out.

Villanueva has been pushing for the conduct of regular, random testing in workplaces, wherein workers would take COVID-19 tests on a weekly basis, to help curb the spread of COVID-19.

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