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House committee to hold dialogue between PhilHealth, hospital group

By MA. ANGELICA GARCIA,GMA News

The House Committee on Health will hold a dialogue between the Philippine Health Insurance Corp. (PhilHealth) and the Philippine Hospital Association on August 24 over an updated PhilHealth circular on the temporary suspension of claims payments.

In a statement, Quezon Representative Helen Tan, chair of the Health Committee, said she called the meeting to clarify the circular and provide a venue to resolve differences.

“We want to hold a dialogue between PhilHealth and the hospitals. We do not want the bridge to collapse. We want to rebuild whatever trust and partnership that is left between the state health insurer and our healthcare institutions or providers," she said.

"We cannot allow this conflict to persist in the face of the worsening pandemic in the country," Tan added.

Earlier, PHA President Dr. Jaime Almora said several hospitals were alarmed by the new PhilHealth circular

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on temporary suspension of payments on claims that are currently under investigation.

He said PhilHealth has yet to settle billions of pesos in reimbursements, adding they are particularly afraid that their COVID-related claims will be declared as "fraudulent" and the tag could unfairly taint the reputation of hospitals.

Almora added that some of their member-hospitals find the new circular "too sweeping."

Meanwhile, PhilHealth spokesperson Shirley Domingo said the state insurer had been implementing the circular since 2016.

Last week, PhilHealth announced its implementation of Circular No. 2021-0013, providing the guidelines on the issuance of TSPC as a preventive measure on healthcare providers that are the subject of an investigation.

The issuance of the latest circular came amid the billions of pesos in unpaid PhilHealth benefit claims from hospitals. — DVM, GMA News