Manila Bulletin
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DOH backs PhilHealth reorganization to improve universal health care services
Philippines
National
DOH backs PhilHealth reorganization to improve universal health care services
DOH backs PhilHealth reorganization to improve universal health care services
Published Jun 25, 2025 06:10 pm
DOH / MB Visual Content Group
The Department of Health (DOH) on Wednesday, June 25, expressed full support for the Governance Commission for GOCCs’ (GCG) approval of the long-anticipated reorganization of the Philippine Health Insurance Corporation (PhilHealth).
In a statement, DOH Secretary Teodoro J. Herbosa said the move aligns with President Marcos’ directive to enhance health services and benefits under the Universal Health Care (UHC) Act.
Herbosa said DOH has been working with the GCG to “ensure that the organizational structure of PhilHealth is suitable for the implementation of Universal Health Care.”
“PhilHealth staff and especially the public have been waiting for this reorg for a long time,” Herbosa said. “The DOH and the entire Board of Directors have paid close attention to every detail,” he added.
Herbosa noted that the structural overhaul was necessary to address long-standing challenges in the agency and to better serve the Filipino public.
“President Marcos, Jr.’s directive to us is to seize this opportunity to make every Filipino feel better about their health, and that is what we will do,” he added.
Major overhaul to improve efficiency, service delivery
In a separate statement, GCG said that it formally approved PhilHealth’s restructuring during its en banc meeting on June 25.
This move, GCG noted, marks a significant milestone in the agency’s efforts to modernize its operations and fulfill its expanded mandate under Republic Act No. 11223 or the Universal Health Care Act.
The restructuring plan introduces a revised organizational structure comprising 503 units and 7,149 positions.
It is aimed at addressing inefficiencies related to workforce limitations, fragmented data systems, and slow benefit claims processing.
Centralization of key services
To ensure streamlined operations, five critical services—finance, legal, information technology (IT), procurement, human resources, and general administration—will be centralized.
This move is expected to eliminate operational redundancies, reduce inconsistencies, and improve responsiveness across all levels of PhilHealth.
In addition, the internal audit office will be strengthened to match the increasing scope and complexity of PhilHealth’s operations.
It will now report functionally to the Audit Committee of the Board of Directors and administratively to the President and CEO of PhilHealth to ensure independence and effective oversight.
New appeals office for benefit claims
One notable innovation in the new structure is the establishment of the Benefit Payment Appeals Office (BPAO), a dedicated unit designed to improve the processing and resolution of appeals related to benefit claims.
The BPAO aims to reduce turnaround times and promote greater accountability in the delivery of healthcare reimbursements.
Timeline of reforms
PhilHealth began the restructuring process in November 2022, submitting initial proposals to the GCG.
Following a partial approval later that year, further consultations and evaluations took place from May 2023 to January 2025, involving extensive documentation and collaboration between the GCG and PhilHealth.
The agency now has one year to fully implement the key organizational changes, with the GCG requiring quarterly reports to monitor progress.
Established under Republic Act No. 10149 or the “GOCC Governance Act of 2011,” the GCG has the authority to reorganize, merge, streamline, abolish, or privatize government-owned or -controlled corporations (GOCCs) in consultation with relevant departments.