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PhilHealth suspends IRM cash advances to hospitals amid controversy

The Philippine Health Insurance Corp. (PhilHealth) has suspended its interim reimbursement mechanism (IRM), amid issues hounding the payment system.

In an advisory made through social media, the state insurer said the suspension will make way for a review of the system and resolve issues moving forward.

"PhilHealth announced the suspension of the Interim Reimbursement Mechanism (IRM) to review its overall implementation and resolve issues arising from Congressional inquiries," the advisory read.

"PhilHealth vowed to find ways to make the IRM more responsive to the needs of healthcare facilities affected by the current pandemic to assure patients of continuous access to needed health services," it added.



The IRM is a system where the PhilHealth pays hospitals and healthcare facilities in advance for insurance claims, to ensure that they could function in crises.

The PhilHealth defines the IRM as "a special privilege for the provision of substantial aid to an eligible Health Care Institution (HCI) directly hit by fortuitous event with clear and apparent intent to continuously operate and/or rebuild the HCI in order to provide continuous health care services to adversely affected Filipinos."

Data released by the state insurer showed that Davao City-based Southern Philippines Medical Center got the highest amount of cash advances so far from the IRM, with P326 million.

It was followed by the UP-Philippine General Hospital with P263 million, and the Davao Regional Medical Center with P209 million.

Its president and chief executive officer Ricardo Morales has since denied outside influence in the release of funds under the IRM.

Just last week, resigned PhilHealth anti-fraud officer Thorsson Montes Keith claimed that the PhilHealth "mafia," composed of the executive committee, stole some P15 billion through fraudulent schemes, including those involving the IRM.

PhilHealth, in a statement, has since denied such claims.

The agency and its officials are also under investigation over the agency's alleged overpriced purchase of an information technology system worth over P2 billion. -NB, GMA News