‘Private hospitals won’t cut ties with PhilHealth’

MANILA, Philippines — Short of saying that the Private Hospitals Association of the Philippines Inc. (PHAPi) was bluffing, Health Secretary Francisco Duque III has expressed doubts that its members will cut ties with the Philippine Health Insurance Corp. (PhilHealth).  

In an interview with “The Chiefs” on One News at Cignal TV Wednesday night, Duque said he was able to talk with a few hospital operators who told him that “they do not share the same sentiments expressed by their president,” referring to PHAPi president Rustico Jimenez.

Asked if the PHAPi pronouncement that its members will not renew accreditation next year was just an empty threat, he said: “I am not in the position to answer that but those that I have talked to, they said ‘no’ (it will not happen)... It does not make sense to do that. Where will they get the funding for their operations? You need cash flow to run your hospital.”

He maintained that while there are delays in PhilHealth’s payment of reimbursement claims, these are primarily due to the incompleteness of documents submitted.  

Duque said PhilHealth is bound to be “compliant with auditing rules and regulations so it cannot be paying without ensuring that the documents are complete and there is a basis for payment to this particular hospital.”

PhilHealth, he added, can also withhold payment because of “fraudulent claims” which may include multiple filing of cases, extended period of confinement and upcasing or declaring “supposed minor cases as catastrophic intensive cases.”

In an open letter to PhilHealth president and chief executive officer Ricardo Morales last Oct. 15, Jimenez had cautioned that PHAPi members were no longer inclined to renew their accreditation as health care providers next year. The latter had complained of delayed payment of reimbursement claims.