Bong Go urges PhilHealth, hospital leaders to work together harmoniously to expedite processing of claims and ensure unhampered health services

Senator Christopher "Bong" Go, during a radio interview on Monday, August 23, shared that, following his appeal for concerned agencies to revisit Circular No. 2021-0013 which halts the "payment of claims that are subject of investigations pertaining to fraudulent, unethical acts, and/or abuse of authority" issued by the Philippine Health Insurance Corporation, a 'fruitful' dialogue transpired among parties concerned to resolve the issues raised.

According to Go, a dialogue between PhilHealth management, the Department of Health, and hospital associations was conducted Monday morning and have been "fruitful" in order to come up with a win-win solution that would not hamper or adversely affect services needed by ordinary Filipinos during this public health emergency.

"At nabalitaan ko naman po nagkaroon... after my appeal kahapon, nagkaroon sila ng fruitful dialogue kanina, ang PhilHealth management, hospital associations and representatives ng DOH," said Go in his recent interview.

"Ako naman po, bilang Committee on Health Chairman, interes ko po na magkaroon ng solusyon at hindi makompromiso ang kapakanan at kalusugan, lalung-lalo na po 'yung mga ordinaryong Pilipino na nakasalalay po sa PhilHealth," he added.

Earlier, Go reached out to PhilHealth President Dante Gierran, Executive Secretary Salvador Medialdea and Secretary Carlito Galvez, Jr. to help resolve some issues raised by hospital associations and protect the stability of the health system.

"Bigyan natin ng palugit dahil iba ang sitwasyon ngayon. May hinaharap pa tayong pandemya at kailangan nating magtulungan para malampasan ito at maproteksyunan ang buhay ng ating mga kababayan," Go earlier said.

"Bagama't sang-ayon ako sa hangarin ng PhilHealth na repormahin ang kanilang sistema para maproteksyunan ang pondo ng bayan laban sa mga namamantala, isaalang-alang rin dapat natin ang mga maaapektuhang ordinaryong mamamayan na walang matatakbuhan at nangangailangan ng tulong, lalo na pagdating sa kalusugan," Go noted.

As the country is still in a public health emergency, Go said that government agencies need to be more flexible so they can prioritize what Filipinos need at this time.

"'Yung mga mapatunayang may fraudulent claims, iyon ang kasuhan. 'Yung mga maayos naman, tulungan natin silang magampanan ang tungkulin nila sa komunidad lalo na ngayon na napaka-importante ng mga ospital dahil tumataas na naman ang kaso ng mga nagkakasakit," Go added.

Go further asked hospitals to follow the proper procedures and be truthful in their claims, particularly in these exceptional circumstances due to the pandemic.

"Sundin lang po natin ang tamang proseso at huwag na pong patagalin pa. Bilisan na po natin dahil malaking bagay ito upang mas makaresponde tayo sa pangangailangang pangkalusugan ng taumbayan," he said.

"Pangalagaan rin natin ang pondo ng bayan at huwag natin palampasin ang mga nangsasamantala," he added.

Various hospital groups announced on August 21 that they were considering terminating their relationship with PhilHealth soon after the state insurer issued a circular about the temporary suspension of claim payments under investigation for fraud.

PhilHealth issued a statement that the temporary suspension of claims payment had been revised, adding that the current circular had been "issued in the spirit of proper fund management and fraud control." The policy will not affect any valid claims, PhilHealth informed its members and licensed providers.

Go stressed the necessity of unhampered health services, especially during the pandemic when Filipinos require urgent access to affordable quality healthcare.

"Napakalaking bagay po 'yan para sa mga hospital natin, umaasa rin po sila sa revolving funds din po nila na gagamitin nila sa pagpapatakbo ng kanilang hospital," the Senator said.

"At kung sakaling madagdagan 'yung pondo nila, mabalik kaagad... ay pwedeng magdagdag rin po sila ng hospital beds, lalung-lalo na po sa panahon ngayon," he added.

Go also appealed to the state insurer and hospital groups to continue working together and maintain a harmonious relationship in order to ensure that their services will not be compromised.

"At ako naman po, umaapela ako sa leadership ng PhilHealth at ng mga hospital groups, na sana tuloy-tuloy ang harmonious and closer coordination. Iisa lang naman po ang hangarin natin dito. Kabutihan po ng lahat, kalusugan at buhay po ng bawat Pilipino po ang inuuna natin dito," said Go.

"So sana po ay tuloy-tuloy na bukas sila sa isa't isa. Huwag na pong umabot sa nai-threaten magsasara... huwag po sana. Dahil ang apektado po dito 'yung mga ordinaryong mamamayan natin na wala pong matakbuhan, wala pong mahingan ng tulong kung hindi itong mga ospital at umaasa sa tulong ng PhilHealth para sa kanilang pampagamot," he added.

The Senator also called on PhilHealth to expedite the processing of unpaid claims even if it will require the hiring of additional personnel.

"Nakikiusap po ako sa PhiHealth, sabi nga ni Pangulong Duterte, kung kakailanganin magdagdag kayo ng tao para mabilisan 'yung proseso, bayaran n'yo na kaagad 'yung mga utang ninyo. What is due sa mga hospital bayaran n'yo na po," he said.

Go then said that his office is always open to listen to the concerns of hospital groups and mediate between them and the state insurer.

"At ako naman po nandirito lang ako sa background parati na handang tumulong po quietly. Kung ano pong puwede kong maitulong sa mga hospital groups na manawagan, papakiusapan ko po si Dante Gierran para mapabilis po 'yung bayad," said Go.

Meanwhile, Go also asked Filipinos in need of medical assistance to seek the services of Malasakit Centers throughout the country on top of what PhilHealth can cover.

"Sa mga pasyente... mga kababayan nating mahihirap po na nagkakaproblema dito sa PhilHealth, uulitin ko lang po. Mayroon tayong Malasakit Center sa 137 na hospital sa buong Pilipinas. Lapitan n'yo lang po 'yan, handang tumulong 'yan," said Go.

"Bukod sa tulong mula PhilHeath, nandyan din ang ibang mga ahensya na handang tumulong sa inyong pampagamot. Basta Pilipino ka, qualified ka diyan sa Malasakit Center," he added.

Signed into law in 2019 by President Rodrigo Duterte, Republic Act No. 11463, otherwise known as the Malasakit Centers Act of 2019, was principally authored and sponsored by Go who serves as Chair of the Senate Committee on Health and Demography.

The Malasakit Centers Act aims to help lower medical expenses to the lowest amount possible through the combined assistance from concerned agencies, such as the Department of Social Welfare and Development, DOH, Philippine Charity Sweepstakes Office, and PhilHealth, placed under one roof.