"This is a sensitive and important issue."
PhilHealth is once more embroiled in multiple controversies amid the COVID-19 pandemic. The national health insurance agency is now under congressional probe for its release of Circular 2021-0013, which temporarily suspends payment of hospital claims under fraud investigation. This is on top of another situation it is currently entangled in concerning billions worth of unpaid claims to hospitals since the start of the pandemic.
Hospital groups and medical organizations are now considering cutting ties with PhilHealth, citing that the circular conveyed mistrust toward them. Some groups even perceive this as PhilHealth’s tactic to delay billions worth of reimbursement from January of last year.
This is a sensitive and important issue that needs to be dealt with fairness and discernment. The suspension of claims payment will affect not only the hospitals but also the thousands of patients who will bear the brunt of this policy. Many have been dependent on PhilHealth for financial assistance to lessen the burden brought by COVID-19. At the same time, we cannot allow hospitals to close at this point. Hence, let me ask PhilHealth to flag these hospitals allegedly involved in fraud, but allow them to operate in this time of need.
Nevertheless, this issue has fortunately brought to surface this long-standing problem in our health insurance system. It is deeply lamentable that fraudulent practices have been going on from 2016 until today when health care is needed the most. Proper investigation, therefore, must be done on the hospitals involved in fraud and other financial and reportorial malpractices. These hospitals which take advantage of this crisis must be heavily penalized for such deplorable acts.
As lawmakers delve into PhilHealth’s questionable measures, let us also be wary of the intent and motives behind these hearings. Do these hearings really bring resolve to the issues at hand? Or are these merely a show? Perhaps we can ask the legislative body to demonstrate utmost impartiality and transparency in its congressional hearings to ensure that solely the interests of the general public are promoted and protected.
As the saying goes, “he who comes to court must come with clean hands”. Let me commend legislators like Rep. Quimbo for their meaningful and relevant questions that really bring out the facts we need to know and the solutions that must be done.
We in the province have been closely monitoring these investigations on PhilHealth. In the future inquiries, I sincerely hope that PhilHealth would be able to present itself free from arrears. I, therefore, ask the agency to reinforce and develop its capacity to detect and investigate fraud in the system. If equipped with an efficient system, there will be no need to suspend payments as the probe of these fraudulent acts can be done swiftly and in a timely manner.
Much is expected of PhilHealth as it continues to help finance COVID-19 treatments to thousands of patients now in hospitals, while being rocked with anomalies and mismanagement issues. In the same way, much is also expected of these legislative hearings as they are supposed to bring resolution and follow through on these matters.
In the end, I pray that the truth and the good come out of all these investigations.
