SEVEN major hospitals in Iloilo City have announced that they are cutting ties with PhilHealth because of unpaid claims amounting to P545 million collectively. These are the Iloilo Directors’ Hospital, Iloilo Mission Hospital, Medicus Medical Center, Metro Iloilo Hospital and Medical Center Inc., St. Paul’s Hospital of Iloilo, The Medical City-Iloilo, and Qualimed Hospital-Iloilo.
In Metro Manila, the Far Eastern University-Dr. Nicanor Reyes Medical Foundation (FEU-NRMF) became the first private hospital to declare that it will no longer renew its accreditation with PhilHealth beginning 2022 because of over P200 million in unpaid claims.
The Private Hospitals Association of the Philippines Inc. warned that more hospitals in Quezon, Isabela and General Santos are planning to disengage from PhilHealth for unpaid claims as well, which means more patients across the country are expected to pay their bills in full and just seek reimbursement.
The increasing number of private and tertiary hospitals disengaging from the Philippine Health Insurance Corp. due to hundreds of millions in unpaid claims is alarming , to say the least. PhilHealth, which oversees the country’s National Health Insurance Program, should immediately resolve unpaid claims to prevent the disengagement of hospitals and build confidence in its ability to run the insurance program, which is essential to affordable healthcare.
How can you provide universal healthcare when you have more and more hospitals giving up their PhilHealth accreditation? This is going to hurt our implementation of the Universal Health Care (UHC) Act because private hospitals are integral to a functional health service provider network, especially in municipalities and cities where there are no public tertiary hospitals.
Even if non-accredited hospitals provide documentation so patients can seek reimbursement from PhilHealth for their medical expenses, this would not work for indigents who need PhilHealth deduction at the point of payment.
PhilHealth must find a way to pay the legitimate claims of accredited health facilities. It is given the budget to perform its mandate — to ensure affordable, acceptable, available and accessible healthcare services through health insurance coverage for all. This is at the center of health reforms in the UHC Act.
