Hontiveros seeks probe into payment claims issues between private hospitals and PhilHealth

Senator Risa Hontiveros has filed a resolution urging the Senate to conduct an investigation on the payment claims issues between the Philippine Health Insurance Corporation (PhilHealth) and private hospitals.

"Ang mamamayang Pilipino ang nalulugi sa bangayan ng PhilHealth at private hospitals. Sa bawat araw na hindi nalulutas ang isyung ito, may mga pasyenteng matinding nag-aalala kung saan kukuha ng pambayad sa ospital. The Senate must investigate because we simply cannot leave the public hanging," Hontiveros said.

According to Proposed Senate Resolution No. 880, PhilHealth issued Circular No. 2021-0013 "suspending payment of claims that are subject of investigations pertaining to fraudulent, unethical acts, and/or abuse of authority" for a period of 120 days.

However, as a result of this directive, the Private Hospital Association Inc. (PHAPi) and the Philippine Hospital Association (PHA) announced that they were "disengaging" with PhilHealth, prohibiting PhilHealth members "for the meantime" to avail of PhilHealth benefits when they go to member-hospitals.

"The temporary suspension of claims may severely impact struggling small hospitals and treatment centers, including healthcare workers who are employed in these facilities. Kung hindi ito maresolba, ang mga Pilipinong manggagawa rin ang lubos na maapektuhan," Hontiveros said.

"Pinaghirapan nating ipasa ang Universal Health Care Act (UHC) para masiguradong lahat ng Pilipino ay may access sa health services at walang sinuman ang kailangang malubog sa utang dahil lang sa isang kapamilyang nagkasakit. Mas lalong dapat tiyakin na walang harang sa paggamit ng health services ngayong panahon ng krisis. We should not allow an impasse during this crucial time of a public health emergency," added Hontiveros, who co-authored and co-sponsored the UHC Act.

The senator said that resolving this issue must be prioritized, especially in light of the confirmed community transmissions of the Delta variant and the detection of a local case of the Lambda variant. She stressed that interruptions in healthcare insurance will have literal life-and-death implications, particularly for the poor and the middle class who cannot afford the full cost of privatized healthcare.

"In the midst of a public health crisis, Filipinos need safety nets in public health emergencies, as well as a financial cushion on the cost of hospitalization. If no agreements are reached between PhilHealth and the private health care providers, the consequences will be borne by the Filipino people who are already reeling from the multiple burdens wrought by the pandemic," Hontiveros concluded.