Recto urges Cabinet execs in PhilHealth board to fix interim reimbursement mechanism

Senator Ralph Recto on Sunday urged Cabinet officials who are members of the Philippine Health Insurance Corporation's (PhilHealth) board to come up with a policy to improve the agency's Interim Reimbursement Mechanism (IRM) amid issues regarding its implementation.

In a Dobol B sa News TV interview, Recto said the "big brothers" of PhilHealth, referring to the Cabinet officials who are part of the agency's board including the Secretaries of Health, Finance, Budget, Social Welfare and Development, and Labor, should initiate the reforms in the IRM.

"'Yung big brothers sa board [na] nakakaintindi dapat niyan, nakaalam niyan, sila 'yung gumawa ng polisiya tungkol diyan sa IRM," he said.

"Ano 'yung magandang polisiya para hindi mawala o mabawasan ang pondo? Ano 'yung formula na dapat gamitin sa pagbibigay ng ayuda?" Recto asked.

The IRM is a system where the PhilHealth pays hospitals and healthcare facilities in advance for insurance claims, to ensure that they could function in crises.

The state health insurer on Thursday 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.

Recto does not necessarily believe that the IRM is a bad policy, although he said there is a need to improve its implementation.

"Ang problema diyan, 'yung corruption, 'yung kuntsabahan, 'yung inefficiency. But as a matter of policy, hindi masama 'yung IRM lalo na sa panahon ng giyera. You're deploying resources to the frontline e," he said.

For instance, the senator said government hospitals should be the first to receive allocations through the IRM, followed by district hospitals in the provinces as well as private hospitals with good track record.

"Wala rin akong problema kung malaki ang binigay doon sa Davao dahil malaking ospital 'yun at magaling naman 'yung nagpapatakbo nu'n," he said, referring to Davao City-based Southern Philippines Medical Center, which PhilHealth said received the highest of compensation under IRM with P326 million.

"Yung PGH (Philippine General Hospital), walang problema diyan," he added.

At the same time, Recto said PhilHealth's "big brothers" should also face the ongoing Senate inquiry to explain what their inputs in the policies of PhilHealth.

"Board ang nagpapatakbo rin ng PhilHealth. Ang polisiya, galing sa board 'yan. So hindi lang 'yung execomm (executive committee) ang may accountability. Palagay ko equally accountable ay 'yung mga miyembro ng board diyan," he said.

Recto said the five Cabinet officials in the PhilHealth board have been invited to attend the continuation of the Senate inquiry on Tuesday, but he did not mention if they accepted the invitation. 

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