PhilHealth to suspend accreditation of ‘unethical’ doctors

The Philippine Health Insurance Corp. (PhilHealth) yesterday warned doctors performing “unethical practices” that their accreditation could be suspended, as it looks into the alleged abuses by some health care providers.

Valentin Guanio, PhilHealth senior vice president for legal services, said they are looking to include unethical practices and abuses of doctors as among the offenses that may lead to the non-renewal of their accreditation to curb the “rampant abuses” of some practitioners.

“The integrity and competence of health care professionals are among the very important elements that patients consider before seeking treatment. But if these are compromised by a doctor’s unethical practices definitely, the patient’s health will be at risk,” Guanio pointed out.

According to Guanio, PhilHealth is currently investigating cases of alleged doctor abuse in the conduct of supposed medical missions wherein they file their claim for reimbursements through the accredited hospitals in their area.

“We are already following up on some leads to enable us to get to the root of the matter soonest and without PhilHealth accreditation these doctors can no longer file for reimbursements,” he said.

Guanio added that PhilHealth is working closely with specialty societies to define the parameters of what may be considered unethical practices.

“Penalties for such offenses will similarly be increased and other policy changes will soon be introduced to further strengthen PhilHealth’s campaign against abuse of medical authority,” he stressed.

Guanio meanwhile clarified that PhilHealth only provides an average of P18,373.00 for cataract extraction.

“It is possible for a skilled ophthalmologist to perform more than a hundred cataract extractions in a month, but such unhealthy circumstances run the risk of infecting, rather than curing, the patients,” he said. – Mayen Jaymalin