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Bong Go pushes for bill strengthening IC's regulatory power over HMOs
Philippines
National
Bong Go pushes for bill strengthening IC's regulatory power over HMOs
Bong Go pushes for bill strengthening IC's regulatory power over HMOs
Published Jun 13, 2023 06:56 am
Senator Christopher “Bong” Go is pushing for a bill seeking to amend the country’s Insurance Code in order to enhance the services of Health Maintenance Organizations (HMOs).
Sen. Christopher “Bong” Go (MB file photo)
Go, chairman of the Senate Committee on Health and Demography, stressed the crucial role of HMOs in providing affordable healthcare coverage to Filipinos. Thus, Go filed Senate Bill No. 425 to amend Presidential Decree No. 612, also known as “The Insurance Code.” The senator said the Insurance Commission (IC) is exercising jurisdiction over HMOs by virtue of Executive Order No. 192. However, the EO does not explicitly state that the Insurance Code applies to HMOs. The bill, he said, seeks to provide a clearer supervision to safeguard the interests of policyholders, promote transparency, and ensure the efficient functioning of the insurance sector. The suggested amendments under the bill, he said, aim to properly regulate and promote a fair and competitive insurance industry. The senator also said the measure explicitly includes HMOs into the law’s regulatory coverage which shall enable the Insurance Commission to provide stricter supervision over them, ensuring that they adhere to high standards of service delivery and financial stability. “Nang dahil sa pandemya, mas nakikita natin ang importansya po ng health insurance. Pero sa totoo lang po, hindi naman po lahat ay masasagot ng PhilHealth (Because of the pandemic, we see more the importance of health insurance. But to be honest, not everything can be answered by PhilHealth),” Go said, referring to the state health insurance agency. “Nakakalungkot po pero karamihan ay umaabot ng malalaking halaga ang hospital bill at hindi naman po lahat ito ay makakayang masagot ng PhilHealth (It's sad but most of the hospital bills reach huge amounts and not all of them can be covered by PhilHealth),” said Go. Thus, he said the measure, will clarify the IC’s jurisdiction over all existing HMOs in the country. Once passed into law, the measure will make HMOs subject to the provisions of the Insurance Code not explicitly provided for in EO 192. “Kahit nasa ilalim ng Insurance Commission ang HMO, ‘di pa rin po malinaw kung nag-apply sa HMO ang mga provision ng Insurance Code. Kaya mas maganda rin na maiklaro sa batas (Even though the HMO is under the Insurance Commission, it is still not clear if the provisions of the Insurance Code apply to the HMO. So it is also better to be clarified in the law),” Go said. By pushing for stricter supervision of HMOs, the bill would address issues such as misrepresentation of coverage, denial of claims, and abrupt termination of contracts. Go added stricter oversight would ensure that HMOs fulfill their obligations to policyholders and provide the healthcare services they are entitled to, without undue delays or complications. The bill also aims to enhance competition in the insurance industry and effectively improve insurance services for Filipinos. “Transparency and financial stability are critical factors in the insurance industry, particularly in the healthcare sector. Under my proposed bill, it would require HMOs to provide clear and comprehensive information about their operations, financial standing, and coverage provisions,” Go stressed. “This transparency would enable policyholders to make well-informed decisions when choosing an HMO and would foster a more competitive and consumer-friendly market,” the lawmaker emphasized.
Sen. Christopher “Bong” Go (MB file photo)
Go, chairman of the Senate Committee on Health and Demography, stressed the crucial role of HMOs in providing affordable healthcare coverage to Filipinos. Thus, Go filed Senate Bill No. 425 to amend Presidential Decree No. 612, also known as “The Insurance Code.” The senator said the Insurance Commission (IC) is exercising jurisdiction over HMOs by virtue of Executive Order No. 192. However, the EO does not explicitly state that the Insurance Code applies to HMOs. The bill, he said, seeks to provide a clearer supervision to safeguard the interests of policyholders, promote transparency, and ensure the efficient functioning of the insurance sector. The suggested amendments under the bill, he said, aim to properly regulate and promote a fair and competitive insurance industry. The senator also said the measure explicitly includes HMOs into the law’s regulatory coverage which shall enable the Insurance Commission to provide stricter supervision over them, ensuring that they adhere to high standards of service delivery and financial stability. “Nang dahil sa pandemya, mas nakikita natin ang importansya po ng health insurance. Pero sa totoo lang po, hindi naman po lahat ay masasagot ng PhilHealth (Because of the pandemic, we see more the importance of health insurance. But to be honest, not everything can be answered by PhilHealth),” Go said, referring to the state health insurance agency. “Nakakalungkot po pero karamihan ay umaabot ng malalaking halaga ang hospital bill at hindi naman po lahat ito ay makakayang masagot ng PhilHealth (It's sad but most of the hospital bills reach huge amounts and not all of them can be covered by PhilHealth),” said Go. Thus, he said the measure, will clarify the IC’s jurisdiction over all existing HMOs in the country. Once passed into law, the measure will make HMOs subject to the provisions of the Insurance Code not explicitly provided for in EO 192. “Kahit nasa ilalim ng Insurance Commission ang HMO, ‘di pa rin po malinaw kung nag-apply sa HMO ang mga provision ng Insurance Code. Kaya mas maganda rin na maiklaro sa batas (Even though the HMO is under the Insurance Commission, it is still not clear if the provisions of the Insurance Code apply to the HMO. So it is also better to be clarified in the law),” Go said. By pushing for stricter supervision of HMOs, the bill would address issues such as misrepresentation of coverage, denial of claims, and abrupt termination of contracts. Go added stricter oversight would ensure that HMOs fulfill their obligations to policyholders and provide the healthcare services they are entitled to, without undue delays or complications. The bill also aims to enhance competition in the insurance industry and effectively improve insurance services for Filipinos. “Transparency and financial stability are critical factors in the insurance industry, particularly in the healthcare sector. Under my proposed bill, it would require HMOs to provide clear and comprehensive information about their operations, financial standing, and coverage provisions,” Go stressed. “This transparency would enable policyholders to make well-informed decisions when choosing an HMO and would foster a more competitive and consumer-friendly market,” the lawmaker emphasized.