Lawmaker to PhilHealth: Settle P18 billion bill

MANILA, Philippines — State-owned Philippine Health Insurance Corp. (PhilHealth) has been urged to settle at least P18 billion in unpaid reimbursement claims of accredited hospitals nationwide.

“This is very urgent specially because we are still facing this coronavirus disease 2019 (COVID-19) pandemic and we all need the full operations of our hospitals with the necessary medical personnel,” Cagayan de Oro City Rep. Rufus Rodriguez said yesterday.

“We don’t want our hospitals to close, downscale services or lay off medical personnel because of non-payment of claims by PhilHealth,” Rodriguez, chairman of the House committee on constitutional reforms, said.

In Resolution 970, Rodriguez quoted claims by the Philippine Hospitals Association of the Philippines (PHAP) that PhilHealth owed its members P14 billion as of December 2018 and P4 billion in 2019.

The group is composed of 733 hospitals with 44,700 beds nationwide.

“One of the reasons why many private hospitals are struggling to respond to the COVID-19 pandemic is because they are running out of funds. Many of them have had to obtain emergency loans to sustain operations,” Rodriguez said.

As an offshoot of financial difficulties, he said hospitals “are retrenching some of their employees to ensure their sustainability.”

“As an example, the University of Sto. Tomas Hospital has reduced its manpower and implemented cost-efficiency measures following ‘significant losses’ inflicted by the pandemic and the delay in PhilHealth payments,” Rodriguez said.

He quoted UST Hospital medical director Marcellus Francis Ramirez as saying that the delay is “an average of five to six months” and that the hospital’s receivables from PhilHealth stand “at more than P180 million.”

“As a result of unpaid claims, PHAP members have signified their intention ‘to hold back or hold in abeyance’ their accreditation with PhilHealth, which would be very detrimental to the Filipino people,” Rodriguez said.

He said PhilHealth has denied that it owed UST and other hospitals millions of pesos in unpaid claims.

Rodriguez urged the House to express its collective sense and urge PhilHealth to settle the matter.

Operating on deficit

PhilHealth collections have dwindled massively due to the lockdown and the state insurance agency will be running on a deficit until 2024 due to payments for COVID-19 patients, PhilHealth president Ricardo Morales said yesterday.

During an inquiry conducted by a joint congressional oversight committee on Universal Health Care (UHC), Morales told lawmakers that the country’s healthcare system may suffer between now and 2024 due to COVID payments amounting to P40.7 billion.

“We will be running a deficit by the end of 2020 and we will be maintaining that deficit up to 2024. This is what it will cost PhilHealth to respond to the COVID-19 pandemic for the entire year from February 2020 to January 2021,” Morales said.

“Our collection is about 10 percent of what it was last year. The collection from the direct contributors has not been significant owing to the absence of commerce. Nobody is paying the premium and the indirect contributors also depend on business activity,” he said.

Morales mentioned a P138-billion proposed subsidy for 2021 to cover indigent members, senior citizens, persons with disabilities and UHC expansion, among others.

He said PhilHealth is taking a “very prudent approach” regarding the delivery of new packages under the UHC.

He recommended a general delay on the implementation of the UHC as well as to postpone the expansion of the primary care benefit. Sheila Crisostomo, Paolo Romero