PhilHealth owes Red Cross P700 million

MANILA, Philippines — The Philippine Red Cross will likely suspend its COVID testing for Philippine Health Insurance Corp. members after PhilHealth failed to pay its balance amounting to over P700 million to the PRC, Sen. Richard Gordon said.

In a radio interview last Saturday, Gordon, who chairs the PRC, said the organization would stop testing those whose payments would be charged to PhilHealth until it settles its balances.

He lamented that PhilHealth did not follow through with payments after initially giving P100 million to the PRC, which conducts the COVID-19 tests for agency.

PhilHealth’s non-payment of P700.5 million will prevent the PRC from being able to order its needed test kits to replenish dwindling supply and force it to stop operations in its testing center in Manila, according to the senator.

Gordon said the PRC also would not be able to open its newly built laboratories in Bacolod, Zamboanga and Cagayan de Oro.

“How can we operate if we do not have enough test kits and we do not have money to pay our med techs and other staff? We have been totally cooperative in all aspects, but we cannot afford to continue if the government, particularly PhilHealth, continues to fail to pay for their lawful obligations,” he said.

The senator also clarified that the PRC would still accommodate walk-in individuals who would like to get tested and who would pay for their swab tests.

“These delays and foot dragging by PhilHealth have been going on from day one of the contract. We sincerely hope for our people’s sake that the government will see its way clear in resolving this unwanted crisis immediately,” he said.

Senators push to scrap IRM

Meanwhile, senators are pushing for the scrapping or reforming of PhilHealth’s controversial Interim Reimbursement Mechanism (IRM) that they lamented was tainted with corruption and irregularities.

Senate Minority Leader Franklin Drilon expressed belief that there is no need to give billions of pesos in cash advances to various hospitals under the IRM, supposedly for the treatment of COVID-19 patients, if the state firm can fast-track the payment of their reimbursements and claims on time.

Drilon said scrapping the IRM, which he described as a mere cash advance to hospitals, would not and should not affect the services that PhilHealth is mandated to provide under the law.

PhilHealth has temporarily suspended the program amid reports of irregularities.

The Department of Justice revealed that it is investigating various corruption schemes in the agency that involved the “exploitation” of the IRM, and PhilHealth’s case rate system, among others.

Before its suspension, PhilHealth officials said P14.9 billion of the P27 billion for IRM have been disbursed.

“PhilHealth programs will not be affected even if we get rid of this IRM. PhilHealth will and should continue to pay for the hospitalization of COVID-19 patients even if we scrap this IRM fraught with irregularities,” Drilon told radio station dzBB.

“Even the name IRM is a misnomer because this is not a system of reimbursement but an advance – one with very weak liquidation procedure,” he said during the Senate hearing last week on corruption at the agency.

What PhilHealth should do, according to the senator, is to speed up the reimbursement or payment of claims of the hospitals that treated COVID-19 patients but were excluded from the IRM, and require the hospitals that received cash advances to liquidate the funds immediately.

He said the creation of the IRM is the result of the slow processing of payment claims in the agency, and that PhilHealth owed hospitals around P18 billion in unpaid claims, based on reports.

Senate President Pro Tempore Ralph Recto said the IRM, as a policy to help hospitals deliver services even during calamities, was good even as he likened the scheme to sending supplies to battling soldiers on the frontlines.

Recto added that the Cabinet officials who sit at the PhilHealth board should reform the IRM. For starters, he said the scheme must prioritize government hospitals in the disbursements.

Private hospitals with good track record can avail themselves of the scheme, according to the senator.