(Philippine Health Insurance Corporation)

The House of Representatives Committee on Appropriations has ordered a special audit into the Philippine Health Insurance Corporation’s (PhilHealth) advance payments program, which has been linked to alleged corruption during the previous Duterte administration.

During a recent oversight meeting of the panel with the Department of Health (DOH), House Deputy Majority Leader and Iloilo 1st district Rep. Janette Garin called on the Commission on Audit (COA) to conduct a special audit into PhilHealth’s Interim Reimbursement Mechanism (IRM).

Garin, a former DOH Secretary, flagged the program over its use of premium contributions from its members to fund hospitals.

“I move that the [COA] conduct a special audit in relation to the conduct of IRM with focus on, first was it legal? Second, was it ethical and proper? And third, was it implemented properly?” she said.

Marikina 2nd district Rep. Stella Quimbo, who presided over the hearing, approved this motion after hearing no objection.

According to PhilHealth, the IRM primarily handles emergency cash advances to healthcare institutions in line with its mandate to continually provide health services to Filipinos affected by natural disasters and calamities.

The IRM was used for Super Typhoon Yolanda in 2013, the Marawi Siege in 2017, the Taal Volcano eruption in January 2020, and most recently, the Covid-19 pandemic.

During the pandemic, the state health insurer advanced P15.5 billion in funds to private and government hospitals.

“PhilHealth is an insurance, tama po ba? Kapag insurance ang ibig sabihin ginagamit ‘yung pera ng mga miyembro kapag kailangan nila kagaya ng pangangailangan sa kalusugan,” Garin told the panel.

(PhilHealth is an insurance, right? Insurance means the money of the members is used for when they need it, such as for health needs.)

“Can you cite any insurance corporation, either government or private na nag-a-advance payment? (that advances payments?) Example, baka masunog ‘yung building, so binayaran mo na muna yung may-ari ng building para kung masunog siya nakabayad ka na,” she underscored.

(Example, the building might catch fire, so you need to pay the owner of the building already so that if it catches fire, you have already paid.)

Garin pointed out that PhilHealth’s funds should strictly be used for healthcare, as she noted that some of IRM’s funding was used for healthcare facilities that did not cater Covid-19 patients.

“The issue here is not kung may namera ba o wala (if they pocketed the money or not), that's just one of the issues,” she said.

“What we are more concerned as legislators and as PhilHealth members is ginagamit ba sa tama ang pera ng PhilHealth na actually pera ng mga miyembro ng PhilHealth. Lalo na yung ating mga indigents na kailangan yung pondo ng PhilHealth kapag sila ay magkasakit (Is PhilHealth's money, which is actuallyPhilHealth members' money, being used correctly? Especially for our indigents who need PhilHealth funds when they get sick),” she continued.

During previous congressional inquiries, it was found out that the IRM funds were disbursed to healthcare institutions that were facing fraud allegations.

The program was also criticized over the alleged politicking involved in the release of the funds.

PhilHealth officials have repeatedly denied such claims of favoritism.