PhilHealth execs liable for larger dialysis clinic releases –Keith

Officials of state insurer Philippine Insurance Corporation are liable for graft for releasing larger reimbursements to dialysis clinics rather than to COVID-19 referral hospitals, former PhilHealth anti-fraud legal officer Thorrsson Montes Keith claimed on Tuesday.

“Parang pinamigay lang ang pera, Sir. May favoritism. May injury po sa government which is in violation of Anti-Graft and Corrupt Practices Act kasi iyong may ibang kailangan ng pondo, walang magamit. Plunder pa nga po kasi more than P50 million ito. Bilyon po,” Keith said during Tuesday's Senate hearing.

“Pero iyong di nangangailangan, andami nilang pera,” he added.

Senator Joel Villanueva, citing PhilHealth records, had pointed out that PhilHealth released the full amount of its advance payments to at least 12 dialysis centers under its Interim Reimbursement Mechanism (IRM) program when IRM releases to COVID-19 hospitals only hovered around 50 to 70 percent.

Furthermore, 29 COVID-19 hospitals, especially those in Batangas, only received 50 to 60 percent of their IRM entitlement.

According to Villanueva, this particularly the case at the Batangas Medical Center, Metro Balayan Medical Center, and the Lipa Medix Medical Center, all of which were located in the Calabarzon Region—the region with the third most number of COVID-19 at around 17,243.

The Batangas Medical Center only received 50.6 percent of its P100 million IRM allotment.

The Metro Balayan and Lipa Medix Medical Centers, on the other hand, received 50.4 percent and 66.2 percent of their P12 million and P72 million IRM allocation, respectively.

“Iyong mga pinagpala at paborito, 100 percent ang release. It appears to me that this IRM is Inequitable Reimbursement Mechanism,” Villanueva quipped.

Discretion

Meanwhile, PhilHealth President Ricardo Morales passed the buck on to the hospitals, saying that it was their discretion as to whether they were going to maximize their IRM allocations.

“Depende po sa pagpapasya ng ospital sa binigay na limit sa kanila, kung gusto ba nila sagarin o hindi,” Morales said.

Villanueva, dissatisfied with Morales’ response, countered that no hospital would turn down the opportunity to maximize the government assistance available to them amid the COVID-19 pandemic.

“What explains the fact that 100% of the IRM of freestanding dialysis clinics were released by PhilHealth when this is not the case for COVID-19 referral hospitals? 100% ang na-release, hindi ba kahinala-hinala ‘yun?,” Villanueva asked.

“Kung ako ang COVID-19 referral ospital, siyempre gusto ko sagarin,” the senator added.

Based on PhilHealth records, the Davao City-based Southern Philippines Medical Center received the largest amount of compensation from PhilHealth for COVID- 19 patients with P326 million.

A far second was the UP-Philippine General Hospital with P263 million followed by the Davao Regional Medical Center with P209 million. — DVM, GMA News