The Department of Health (DOH) on Friday, Nov. 15, announced that the Benefits Committee (BenCom) of the Philippine Health Insurance Corporation (PhilHealth) has recommended to the Board en banc enhanced benefit packages for heart attacks, ten rare diseases, preventive oral health services in primary care, peritoneal dialysis, and assistive mobility devices.
The PhilHealth Board of Directors is chaired by DOH Secretary Teodoro J. Herbosa. In a statement released by DOH Officer-in-Charge (OIC) Assistant Secretary and Spokesperson Albert Domingo, it was announced that the Board en banc will have its next regular meeting before the end of this month.
“The job of PhilHealth is to pay the health benefits of its members,” said Secretary Herbosa. He added that the standing instruction of President Marcos for the DOH is to “steer PhilHealth along these lines” through its Board.
“Today's BenCom endorsement is one of many that the DOH has been leading in that regard,” he added.
DOH noted that there are eight major steps needed to implement a new PhilHealth benefit or enhance an existing one. These include benefit development; policy development; policy approval; IT system development; publication; IT system enhancement; user training/orientation; and effectiveness assessment.
“Board action is found in only two of these eight: policy development and policy approval,” DOH said, adding that the other six steps fall under the direct control of Management, the President, and the Chief Executive Officer (CEO).
Improved benefits
DOH noted that the improved benefits endorsed for Board approval include a package for acute myocardial infarction (AMI) or heart attacks across the continuum of care; ten rare diseases, including Maple Syrup Urine Disease, Methylmalonic Acidemia/Propionic Acidemia, Galactosemia, Phenylketonuria, Gaucher Disease, Pompe Disease, Fabry Disease, MPS II (Hunter Syndrome), MPS IV (Morquio Syndrome), and Osteogenesis Imperfecta; preventive oral health services to complement the PhilHealth Konsulta package; improved coverage for Peritoneal Dialysis; and assistive mobility devices for priority conditions that affect those most in need of physical rehabilitation.
“To lower the health expenses of Filipino families, radical change must happen from within PhilHealth,” Herbosa said. “It has to do better—settling all arrears, paying reimbursement claims faster, and increasing cost coverage,” he added.