House panel to scrutinize PhilHealth's P14-B IRM cash advances to hospitals

A House committee probing the alleged irregularities at PhilHealth will look into the state health insurer's P14-billion advance payments to hospitals for COVID-19 patients "for any sign of fraud."

"We will examine those payments in detail for any sign of fraud and/or overpayment," said Anakalusugan Representative Mike Defensor, chair of the public accounts committee, in a statement Friday.

"We have already asked PhilHealth to submit all supporting documents."

Defensor was referring to PhilHealth’s Interim Reimbursement Mechanism (IRM), controversial after it was learned during a Senate hearing that the largest chunk of the fund went to dialysis centers as well as to hospitals in regions where there is no high humber of COVID-19 cases.

Based on the Commission on Audit’s (COA) records, PhilHealth was only able to liquidate P1 billion of the P14 billion IRM fund it released amid the COVID-19 pandemic.

"We hope to get the supporting papers next week. These should indicate the amounts advanced, the recipient-hospitals, amounts liquidated, number and classification of new coronavirus disease cases, number and names of patients, medicines given, and the treatment patients received," Defensor said.

PhilHealth has earlier set case/package rates for COVID-19 cases:

• P43,997 for mild pneumonia
• P143,267 for moderate pneumonia
• P333,519 for severe pneumonia and
• P786,384 for critical pneumonia/coronavirus disease.

PhilHealth's former anti-fraud officer Thorrsson Montes Keith accused PhilHealth’s senior officials of pocketing P15 billion through several fraudulent schemes, including the IRM for hospitals for COVID-19 cases, cash advances and the continuous procurement of IT equipment the agency already has.

These allegations have since been denied by PhilHealth officials. Nevertheless, it has suspended the IRM amid issues hounding the payment system. —Llanesca T. Panti/KBK, GMA News