PhilHealth claims exceeded number of admitted COVID-19 patients in 4 regions —solon

The number of Philippine Health Insurance Corporation (PhilHealth) claims for reimbursement of hospitalization of COVID-19 patients exceeded the number of patients admitted to hospitals, House Deputy Minority Leader Stella Quimbo said Thursday.

Quimbo, citing records from the Department of Health and the PhilHealth Central Office submitted to the House joint panel on Public Accounts as well as Good Government and Public Accountability, noted that the discrepancy happened in Region 1, Calabarzon or Region 4A, Mimaropa or Region 4B and Region 6.

Quimbo cited that the number of PhilHealth claims exceeded the number of those hospitalized due to COVID-19 by 58% in Region 1; 87% in Region 4A;  12% in Region 4B; and 47% in Region 6.

“Napakalaki po ng excess. Halos doble po. Sa isang region, pwedeng umabot ng P34 million [ang excess payout of PhilHealth claims],” Quimbo said during the House inquiry on alleged PhilHealth corruption.

Dr. Israel Pargas, PhilHealth Senior Vice President explained that not all claims filed were approved by PhilHealth. He also said COVID-19 patients admitted in hospitals are yet to file for PhilHealth claims, and that the claims also included probable and suspect COVID-19 cases.

“Maaari po kasi na those claims ay hindi pa po na-i-file sa amin kasi may 120 days ang ospital para mag-file dahil po may fortuitous event ngayong COVID-19,” Pargas said.

Quimbo did not buy it, saying that the data she presented only covers PhilHealth claims under hospital case rate which is worth P43,000 at the minimum and did not include the agency's isolation package used for probable and suspect cases which is worth P22,000.

“Kahit sabihin nyo pong may delay, labis labis pa rin po ang availment rate ng regions na ito,” Quimbo said.

Pargas conceded that there is a need to improve the policy, and that PhilHealth will appreciate inputs from Congress.

The House probe on PhilHealth corruption mess will resume next week. —LDF, GMA News