PhilHealth admits giving IRM funds to healthcare institutions with pending cases

The Philippine Health Insurance Corp. (PhilHealth) on Thursday admitted that it had provided funds to healthcare institutions through the controversial interim reimbursement mechanism (IRM) even as these facilities have pending cases.

During the continuation of the House joint panel hearing on the alleged irregularities at PhilHealth, Cavite Representative Elpidio Barzaga Jr. asked the agency's senior vice president Dr. Israel Pargas about funds allegedly given to healthcare institutions with pending cases.

House committee on public accounts chair Mike Defensor alleged in a previous hearing that PhilHealth released around P1.4-billion worth of IRM funds to 51 healthcare institutions

"Policy ninyo rin ba sa IRM na 'yung may mga pending cases, binigyan ninyo pa rin ng IRM? Totoo ba yun o hindi?" Barzaga asked.

In response, Pargas said: "Yes, Mr. Chair."

Barzaga proceeded to ask if PhilHealth did not make it as a policy not to provide IRM funds to healthcare institutions with pending cases.

But before Pargas could even finish his explanation, Barzaga cut him off and asked him to present a document stating that healthcare institutions with pending cases could still receive IRM funds.

Pargas replied that it was made during their executive meeting.

In a previous hearing, Defensor questioned why these institutions still got IRM funds even as they have a record of fraudulent cases.

"Pagpalagay natin, may nakita ako isa o dalawa, katulad nung St. Lukes, Medical City, ang pinagtataka ko bakit hindi ni-resolve ang fraud cases bago nag-release ng IRM?" he said.

Defensor expressed concern that allocating IRM funds to healthcare institutions with fraudulent cases would set a bad example.

"With so many hospitals here in Metro Manila, in other provinces, we should not allow those that have fraud cases, those that have penalties, to continue to have such funds," he said.

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

PhilHealth, in a statement, has since denied such claims.—AOL, GMA News