Hospital owners, doctors oppose Philhealth circular on preventive suspension

MANILA, Philippines - Doctors and hospital owners opposed a Philippine Health Insurance Corp. (Philhealth) circular imposing a 90-day preventive suspension on member-hospitals and clinics with pending administrative cases.

According to Bum Castro, a doctor and a lawyer, the Philippine Medical Association (PMA), the Philippine Hospitals Association of the Philippines (PHAP) and the Philippine Hospital Association (PHA) find Philippine Circular No. 47-2009 “oppressive” as it penalizes members even before they are found guilty of the charges.

“It’s penalizing the members because you cannot claim (reimbursement from Philhealth) during the period of suspension when your case is still being investigated,” said Castro, spokesman of PMA, Board director of PHA and legal counsel of PHAP.

Under the circular, Philhealth member-hospitals and clinics will be suspended for 90 days while the administrative charges for fraudulent claims and other violations against them are being heard.

The move was made amid reports that many members continue to commit violations despite the charges.

Castro noted that at present, Philhealth has not imposed any suspension but if it does so, the three organizations would stop recognizing the Philhealth membership of patients.

“That means that they have to pay from their own pockets. Anyway, they can reimburse from Philhealth later on... We’ll be suspending ourselves,” he added.