PhilHealth says 98% of ‘stolen’ P15B already liquidated

The Philippine Health Insurance Corp. (PhilHealth) has maintained that the controversial P15-billion in advanced payments through its interim reimbursement mechanism (IRM) is not missing as it reported that 98% of the amount has been liquidated.

In a statement posted on its Facebook page on Saturday, PhilHealth said, “P15 Billion, Hindi Nawala! (P15 Billion, Not Lost!).”

The state health insurer said the amount went to 711 hospitals as subsidy and to keep the health facilities open for patients in need of medical attention amid the pandemic.

“Properly accounted ito. Sa katunayan ay P14.7 billion o 98% na ang na-liquidate o naisulit na ng mga ospital, katunayang pinakinabangan ito ng mga pasyente at hindi ng bulsa ng sinoman,” PhilHealth noted.

[This is properly accounted for. In fact, P14.7 billion or 98% have been liquidated or disbursed to hospitals, meaning this has benefitted patients and not anyone’s pockets.]

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

Specifically, PhilHealth defines the IRM as "a special privilege for the provision of substantial aid to an eligible Health Care Institution 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."

Congressional investigations last year found that IRM funds were also transferred to dialysis centers, infirmaries, and maternity centers even as they could not be considered as responding to "fortuitous" events.

PhilHealth has since suspended its IRM system "to review its overall implementation and resolve issues arising from congressional inquiries."

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

PhilHealth has denied such claims. —KG, GMA News