ILOILO City – A really big problem. This was how Mayor Jerry Treñas described Philippine Health Insurance Corp.’s (PhilHealth) temporary suspension of payments for claims that are said to be subject of investigation.
With the suspension coming at a time when hospitals and the molecular laboratory in this city are getting financially hard-up, Treñas said “presidential intervention” is needed.
“Otherwise mamroblema, punuan ang mga hospitals,” the mayor said in a radio interview.
But Treñas said he already saw this coming. Unpaid claims of hospitals since the coronavirus disease 2019 (COVID-19) pandemic started last year have ballooned to P1.1 billion.
For the Uswag Molecular Laboratory whose unpaid claims accumulated to P200 million, PhilHealth managed to settle P1 million only, said Treñas.
The mayor said he already wrote PhilHealth president and chief executive officer Dante Gierran regarding the concern.
Chief Presidential Legal Counsel Salvador Panelo, who was in Iloilo last week, was also furnished a copy of the letter. He called someone from PhilHealth and was told that the state insurer already paid the claims of Iloilo City hospitals.
Treñas quipped, “I know the real score…I am really very worried what will happen to our health system.”
There might already be a problem with the cash flow of PhilHealth, according to Treñas.
He recalled telling an official of the PhilHealth office here, “Ano puto na gid kamo?”
Friday last week, PhilHealth issued Circular No. 2021-0013 suspending the payment of claims “that are subject of investigations pertaining to fraudulent, unethical acts, and/or abuse of authority.”
This policy has been in place since 2016, it stressed, citing PhilHealth Circular 2016-026 issued to ensure “proper fund management and fraud control”.
Shirley Domingo, spokesperson and vice pPresident for Corporate Affairs of PhilHealth, emphasized that the circular introduced additional provisions to ensure due process is observed before a TSPC (Temporary Suspension of Payment of Claims) is finally issued “to allay fears of alleged arbitrary investigations among our providers.”
“Fraud control is a basic tenet in managing funds. Hence, PhilHealth finds it imperative to implement measures to ascertain the security and sustainability of funds entrusted to it,” Domingo said.
She assured PhilHealth members and accredited providers that all “good claims” won’t be affected.
In the meantime, said Treñas, the city government is taking steps to help city hospitals by opening additional beds dedicated to COVID-19 patients at the St. Therese Hospital which now serves as the city’s quarantine facility.
The facility will be the extension hospital of The Medical City, he said./PN
