Press Release
February 18, 2008


Senator Edgardo J. Angara today stressed the need to define and criminalize abuses and unethical practices of health care providers as saying that it poses an inevitable threat to the National Health Insurance (NHI) Fund.

"The billions of pesos in benefit payment are really irresistible to some unscrupulous health care providers. Though there is no statistical and hard data to measure the amount of fraudulent claims, still this has to be put to an end. The abuses and unethical practices are getting sophisticated, evolving to new methods and techniques of violations along very generations of social health insurance," said Angara, who authored the National Health Insurance Act in 1995 that created the Philippine Health Insurance Corporation (PhilHealth).

He added, "PhilHealth will not only focus on the filing of cases on violations of health care providers, but also against employers. These employers are considered partners in the effective implementation of the program and for this reason, they should be constantly reminded that the non-registration, non-deduction and non-remittance of the premium contributions of their employees will lead to the collapse of the program."

With this, Angara has recently filed a bill amending the 1995 National Health Insurance Act to define the offenses and abuses against the National Health Insurance Program as well its equivalent penalties and sanctions.

Under Senate Bill 2010, the amount of fine is increased from the existing P10,000 to P50,000 bracket to a range of P50,000 to P100,000 with a discretion on the part of PhilHealth to impose such fine or suspension from three months to the whole term of accreditation against the erring health care provider.

On the aspect of erring employers, it will include the penalties to be imposed for failure to register and or deduct/remit contributions of their employees and that violations of this nature may constitute criminal or civil actions or both.

To avoid arduous litigation process, the bill proposes imposition of interest and surcharges of three percent per month or at any rate as maybe fixed by the Corporation in case of delay in the remittance of premium. This same provision has been lifted verbatim in the Social Security Act of 1997.

PHILHEALTH also extends its coverage, acknowledging the role of the informal sector in the society. The concept, Kalusugang Sigurado at Abot-Kaya sa PhilHealth Insurance (KASAPI) will now target organized groups belonging to the informal sector for a group enrollment to the insurance program. The informal sector will now be embodied in the current representation of self-employed subgroup.

"By providing PHILHEALTH with enforcement power and authority, it can drive down the incidence of fraudulent claims as well as discipline erring health care providers. I believe that by clothing PHILHEALTH with proper authority, it can effectively implement the National Health Insurance Program and eventually protect the NHI Fund," said Angara.

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