President Rodrigo Duterte has expressed alarm over the high price that the Philippine Health Insurance Corp. (PhilHealth) pays to hospitals and testing centers for COVID-19 testing, a Palace spokesman said Friday.
In a radio interview, Presidential Spokesman Harry Roque said the President wants an investigation into why PhilHealth pays P8,150 for a COVID-19 test that the Philippine Red Cross (PRC) can perform for P4,000.
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On Tuesday, Senate Minority Leader Franklin Drilon said the country might lose over P8.3 billion due to the high price PhilHealth pays for tests.
He said PhilHealth’s payment of P8,150 per COVID-19 test was double the P4,000 per test done by the Philippine Red Cross.
Drilon also noted that PhilHealth’s cost estimate is more expensive than the PHP1,500 price tag for each COVID-19 test kit in China.
Roque said Duterte could not also understand why the price of test kits that PhilHealth pays for need to be so costly.
“He, like the public, could not understand why the discrepancy has to be that huge,” he said.
Drilon said the country would lose P8.3 billion if PhilHealth pays P16.3 billion to test 2 million Filipinos.
PhilHealth president Ricardo Morales, in a statement read by Chief Presidential Legal Counsel Salvador Panelo on Friday, said the P8,150 per test was “based on data collected before April 1, 2020, when there was very limited testing capacity.”
“To date, no single COVID-19 test has been paid by PhilHealth, except those being performed by the Philippine Red Cross,” Panelo said, citing Morales’ statement.
Morales said the state-run corporation will soon release a new package rate for COVID-19 patients by next week.
“And as more COVID-19 related medicines and medical supplies become more available, the price of testing is going to decline,” Panelo said, quoting Morales.
Morales also said that all claims containing COVID-19 testing will be checked as to the source of the test kit and its manner of acquisition, and the hospital would be reimbursed accordingly.
Meanwhile, in response to the government’s aim to conduct expanded targeted mass testing of 1.5 to 2 percent of the country’s 110 million population to detect, isolate and treat those with the COVID-19 disease, PhilHealth has formalized a joint undertaking with the PRC.
Under the agreement, PRC will provide COVID-19 testing services using real-time polymerase chain reaction (RT-PCR) tests.
An initial P100 million was released to the PRC which will be replenished once liquidated.
Due to global shortage of testing kits and limitations in local capacity for testing, only the following will be granted free tests:
1. Patients or health care workers with severe or critical symptoms, relevant history of travel or contact;
2. Patients or health care workers with mild symptoms, with relevant history of travel or contact, and considered vulnerable;
3. Patients or health care workers with mild symptoms, relevant history of travel or contact; and
4. Patients or health care with no symptoms but relevant history of travel or contact.
In the Senate, Drilon said PhilHealth should peg the price of COVID-19 testing at P3,500, the amount it pays to the Philippine Red Cross that has conducted 45 percent of COVID-19 tests in the country.
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“If COVID-19 tests could be done for as low as P3,500 as proven by Red Cross, which emerged as the lead testing center for COVID-19, then there is no justification for higher rates set by PhilHealth,” Drilon said in a statement Friday.
“Why would PhilHealth have different prices for the same test? I am glad that PhilHealth listened to us,” he added.
Drilon also doubted claims made by Morales that no actual payments were made to hospitals and testing centers.
Drilon cited a press release that was posted in the agency’s website claiming that the health insurance agency downloaded P30 billion last March to its accredited hospitals “to help them respond to the onslaught of COVID-19 in the country.”
The amount, which used its interim reimbursement mechanism (IRM), is equivalent to three months’ worth of claims based on historical data, which will be charged to their future claims, Drilon said citing PhilHealth’s pronouncements.
Drilon urged PhilHealth to recover overpayments to hospitals, which were given advance payments for COVID-19 tests.