PhilHealth asked to suspend controversial order on claims

August 24, 2021 Ryan Ponce Pacpaco 526 views

THE House committee on health on Tuesday adopted a motion urging the Philippine Health Insurance Corporation’s (PhilHealth) to study, revise or suspend its controversial order on the Temporary Suspension of Payment of Claims (TSPC) against hospitals’ claims suspected of being fraudulent.

The panel chaired by Quezon Rep. Angelina “Helen” Tan approved the motion of Nueva Ecija Rep. Estrellita “Ging” Suansing asking the PhilHealth to put on hold its Circular 2021-013, stressing the implementation is ill-timed as improper enforcement could hamper the operations of government hospitals in the fight against coronavirus diease-19 (COVID-19).

“Gusto ko lang po sanang manawagan at gagawin ko ito hindi lang bilang miyembro ng Kongreso at tagapanguna ng komiteng ito kundi higit sa lahat bilang Pilipino – kung maaari lang po ay liwanagin natin ito ng mabuti, makinig tayo sa paliwanag ng bawat isa, at magtulungan tayo. Isipin po sana natin at unahin higit sa lahat ang kapakanan ng ating mamamayan na nasa gitna ng matinding panganib na dulot ng pandemya,” Tan said in the earlier part of the hearing.

“Perhaps, PhilHealth can walk us through the rationale of this circular, especially on its impact on the hospitals and healthcare institutions or providers and in the delivery of health services; while the hospital groups can tell us what they see as the possible repercussions of the circular and what compromise can be made so we can move on to address the more pressing concerns of delivering health services to the public amid the COVID-19 health crisis,” Tan added.

Initially, Suansing moved to suspend the controversial PhilHealth’s circular that Nueva Ecija Rep. Micaela Violago seconded and approved by the committee.

But Suansing revised her motion and instead urged the PhilHealth to review and possibly suspend the circular so that all stakeholders will be properly consulted.

The Tan panel held a dialogue Tuesday between the PhilHealth and the Philippine Hospital Association (PHA) in connection with the issue of an updated PhilHealth circular on TSPC.

During the hearing, PhilHealth defended the circular, explaining it is meant to protect the funds of the agency and fight the fraudulent claims by some hospitals.

PHA, Private Hospitals Association of the Philippines (PHAPi), and Philippine Medical Association (PMA) declared that they were “disengaging” with PhilHealth and warned that the bridge between the PhilHealth and the healthcare providers is “bound to collapse.”