State insurer Philippine Health Insurance Corp. (PhilHealth) will get some P34.99 billion in 2023 to improve its benefit packages under the Universal Healthcare Act.
The development comes as the Philippine Charity Sweepstakes Office (PCSO) and the Philippine Amusement and Gaming Corporation (Pagcor) on Monday signed a joint circular on the guidelines for the remittance of funds for the Universal Healthcare Law.
Under the law, 50 percent of the government’s share from the income of Pagcor and 40 percent of PCSO funds will be transferred to the Bureau of Treasury and then to PhilHealth through the General Appropriations Act to improve its benefit packages.
From 2019 until 2021, the PCSO and Pagcor have accumulated some P1.66 billion and P33.332 billion, respectively, to fund the UHC Law.
“Our fund pool for PhilHealth’s individual-based services is ready and available and shall be released promptly consistent with the DOF (Department of Finance), DBM (Department of Budget and Management), DOH (Department of Health), Pagcor, PSCO, PhilHealth UHC remittance guidelines,” PCSO chairman Anselmo Pinili said in a press briefing.
“Your P20 bet… is not a wager, but a contribution to the health programs of the government. At PCSO, your bet is for charity,” he said.
PhilHealth said the following were among the benefit packages that will be improved:
• Select medical and surgical procedures
• Expansion of case rates for hemodialysis up to 156 sessions
• Enhancement Z benefit packages for selected orthopedic implants
• Post kidney transplant
• Breast cancer, prostate cancer, cervical cancer
• Open heart surgery for children (ventricular septal defect and tetralogy of fallout) and
• Physical medicine and rehabilitation
The law’s full implementation will “take years,” said PhilHealth spokesperson Shirley Domingo.
“This is an omnibus law related to health reforms. There are so many components we cannot immediately implement [them] at once. We were given six years to transition to the full implementation of the law,” said Health Undersecretary Mario Villaverde.
“Now we are in the third year, we hope in the next three years we will be able to enforce all provisions under the law,” he said.
Some provisions, such as the automatic membership of all Filipinos in PhilHealth, have already been implemented, Domingo said.
When asked about PhilHealth’s delayed reimbursements to private hospitals, Domingo noted that the state insurer has been releasing funds through regular processing and its debit-credit payment mechanism.
“We continue to do reconciliation meetings with them. We have expedited the release of reimbursements to them,” Domingo said.
PhilHealth President Dante Gierran said the infusion of funds from Pagcor and PCSO will help them achieve Universal Health Care, especially where improving member benefits is concerned.
The agencies involved said the remittance guidelines provide mechanisms for the transparent, accountable, timely, and sustainable fund provision for benefits improvement of the National Health Insurance Program (NHIP).