Drilon wants PhilHealth's interim reimbursement mechanism revoked

Senate Minority Leader Franklin Drilon on Sunday called for the abolition of the Philippine Health Insurance Corporation's (PhilHealth) interim reimbursement mechanism (IRM) amid issues hounding the payment system.

In a Dobol B sa News TV interview, Drilon said the IRM does not serve the purpose as stated in its name but instead only makes cash advances to hospitals and healthcare facilities.

"Itigil na itong IRM. Kaya nagkakaroon nito dahil ang bagal ng pagbayad ng PhilHealth doon sa mga claimants under the PhilHealth regular program," he said.

"Ibig sabihin ang mga ospital ay hirap na hirap na, marami silang mga serbisyo na nagawa na at humihingi ng reimbursement sa PhilHealth, hindi naibibigay ang reimbursement," he 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 during crises.

Last Thursday, the state health insurer announced that it has suspended the IRM "to review its overall implementation and resolve issues arising from Congressional inquiries."

"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.

Drilon said that despite the suspension of IRM, PhilHealth benefits for COVID-19 cases still continue.

"Ang sinuspinde yung further advances, ang patuloy na pag-advance ng pondo para sa COVID," he said.

For this reason, the senator said there will be no need for the IRM if only PhilHealth will fix its payment system.

"Kung ayusin na nila ang sistema at mabilis ang pag-reimburse ng claims sa PhilHealth, hindi kailangan ang interim reimbursement mechanism," Drilon said.

"Doon pa lang sa pangalan na reimbursement, mali na e dahilan sa hindi naman yan totoo na reimbursement kundi advances," he added.

PhilHealth president and chief executive officer Ricardo Morales has denied allegations of "outside influence" or "palakasan" in the release of funds under the IRM being practiced for hospitals to get early releases. —LBG, GMA News