PhilHealth chief Gierran says agency hurting amid controversies

PhilHealth president Dante Gierran on Thursday lamented before lawmakers how the state-run agency is hurting from the recent controversies hounding it, including unpaid hospital claims.

"Ito sasabihin ko na po: bugbog na po kami. I open my heart, bugbog na po kami," Gierran told the House Committee on Good Government and Public Accountability looking into PhilHealth's unpaid claims to healthcare facilities.

(I will tell you: We are hurt. I'm opening my heart, we are really hurting.)

At present, PhilHealth is said to have P21.1 billion in unpaid claims to hospitals.

Gierran said Philippine Hospitals Association president Dr. Jaime Almora had apologized to him for "overreacting" on the issue of the temporary suspension of payments on claims that are under investigation.

"No less than 'yan si Dr. Almora, tumawag sa akin, nagso-sorry po sa akin na he was just overreacting," Gierran said.

"Ito sasabihin ko na, ano ibig sabihin ng overreacting? Eh nag-overreact lang pala siya. You see? It's unfair, Mr. Chair, na kami lahat ang mali," he added.

(No less than Dr. Almora has called me, apologizing for overreacting on the issue. What does that mean? Apparently they just overreacted. You see? It's unfair, Mr. Chair, that we are being criticized.)

Batangas Representative Mario Vittorio Mariño said there was miscommunication between PhilHealth and hospitals and healthcare providers.

He urged PhilHealth to address this and communicate with the hospital groups.

"Ang sinasabi ko po sa inyo 'yung sentimiyento ng private hospitals. Ang pakiramdam po nila ay sila ay na-prejudge na rin natin," Mariño said.

(I'm telling you the sentiments of the private hospitals. They feel that they are being prejudged.)

Almora had bared that several hospitals are alarmed by the PhilHealth circular on the temporary suspension of payments on claims that are currently under investigation.

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

PhilHealth's Circular No. 2021-0013 provides the guidelines on the issuance of Temporary Suspension of Payment of Claims as a preventive measure against healthcare providers that are subject of investigation. —KBK/RSJ, GMA News