Several senators welcomed the decision of PhilHealth to suspend the implementation of its Interim Reimbursement Mechanism (IRM) for COVID-19 amid various issues arising from ongoing investigations in Congress.
Senate Majority Leader Juan Miguel Zubiri called it a "good first step" as he underscored that this will allow the Commision on Audit and the Office of the Ombudsman to scrutinize the earlier releases PhilHealth made through the IRM.
He said the suspension of the IRM was necessary "especially after the admission of our government monitoring agencies that they were only able to liquidate P1 billion out of the P14 billion already released by the PhilHealth to the different private and government hospitals and clinics."
The IRM releases were "highly irregular" and "prone to corruption" due to the absence of a clear disbursement mechanism, according to Zubiri.
"This system should be stopped until a proper accountability system is set in place," he added.
The IRM refers to PhilHealth's cash advances to healthcare institutions (HCIs) affected by natural disasters, calamities, and other fortuitous events.
Senator Francis "Kiko" Pangilinan said the suspension of the IRM is long overdue.
"It's a step that should have been done earlier. Kung binubulsa ang COVID funds sa IRM system, bakit itutuloy ang sistema? Pag tumutulo ang balde dahil may butas, isasarado muna natin ang gripo at tatapalan ang butas para maayos ang pag-imbak ng tubig, ‘ika nga," he said.
Pangilinan recommended the creation of an independent body composed of state auditors, Department of Health officials, and credible PhilHealth executives to "purge" the state insurers' of unauthorized recipients.
PhilHealth has so far released P14.9 billion through the IRM mechanism. Its president and CEO, Ricardo Morales, explained during a Senate hearing that the 90-day historical claim of hospitals was used as the basis for the IRM allocation, pointing out that the amounts were not arbitrarily decided.
IRM's implementation amid the pandemic has been heavily questioned by senators as dialysis centers and maternity clinics have apparently been prioritized compared to hospitals that are actually handling COVID-19 cases.
'Resolve issues swiftly'
Senator Risa Hontiveros also welcomed the IRM suspension but said the corrective measures should be made efficiently so that healthcare facilities with pending valid claims will not suffer.
"We will have to ask both the COA and the PhilHealth internal audit mechanism ano 'yung reasoble na pinakamabilis na mechanism na puwedeng i-resolve ito... para hindi mabitin 'yung mga may valid pending claims," she told reporters in a virtual interview.
B. Braun Avitum Philippines Inc., the dialysis center that was mentioned several times in the past two Senate hearings, stood by the regularity of its transactions with PhilHealth and vowed cooperation with the government.
"Kung sinasabi nilang marami silang natulungan o maayos nilang ginamit 'yung IRM, kailangan pumailalim sila sa kumpleto at tamang luquidation to the satisfaction of the Senate and eventually of the PhilHealth management," Hontivero said, referring to B. Braun Avitum.
Further, she said that among the possible recommendations that may be included in the Senate Committee of the Whole report is to limit the IRM releases only to healthcare institutions catering to COVID-19 patients.
Along with this proposition, the senator added that the panel may also recommend cutting the turnaround time of the regular reimbursements of PhilHealth for non-COVID-19 claims.
Despite the IRM's suspension, PhilHealth assured its members that benefits for COVID-19 patients will continue. —KBK, GMA News