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Roque to PhilHealth: Pay hospital claims, sack erring officials

Presidential spokesperson Harry Roque on Monday called state-run Philippine Health Insurance Corporation (PhilHealth) to pay private hospital claims as soon as possible and clean its ranks of erring personnel.

Roque made the call in light of private hospitals' threat to cut ties with PhilHealth by next year due to the state-run corporation’s refusal to pay the claims of hospitals and healthcare institutions or providers that are subject to investigations.

"Under the Universal Healthcare law, it is the government which will buy medical goods and services. This (unpaid PhilHealth dues) will derail the UHC law," Roque said at a press briefing in San Mateo, Rizal.

"I will not allow that. Ang panawagan ko sa PhilHealth, magbayad kayo. Hindi po ito tungkol sa kakulangan ng pondo [PhilHealth should pay up because this is not about lack of funds]," he added.

The UHC law, signed in February 2019, provides that all Filipino citizens are automatically enrolled into the National Health Insurance Program as direct contributors or those who have the capacity to pay premiums, and indirect contributors sponsored by the government such as indigents and senior citizens.

Roque, who was a principal author of the UHC law during his stint as a party-list representative, said that 70% of the hospitals in the country are private, and as such, them disengaging with PhilHealth will be a big problem especially amid the COVID-19 pandemic.

"Yes, there are anomalous hospital claims, but these claims should be put on trial. Fictitious claims should not result in blacklisting of the hospital. Government hospitals won’t be enough to take care of our people, especially in the middle of a pandemic," he said.

"PhilHealth should cooperate with private hospitals and pay up as soon as possible,” Roque added.

Private hospitals earlier decried PhilHealth’s arbitrary denial of hospital claims worth P13.8 billion. 

Roque called on PhilHealth chief Dante Gierran to fire officials given that he was named to the post after the agency was accused of paying billions of pesos in fraudulent hospital claims.

"Only one of their officials was removed, and this person even resigned. Ibig mo sabihin isa lang roon ang dapat sibakin? Hindi kapanipaniwala 'yan [Removing only one official after all that has happened is hard to believe],” Roque said.

During a congressional hearing last week, PhilHealth acting vice president for health finance policy sector Clementine Bautista said they will review and amend their policies that are deemed inconsistent with the UHC law.  —KBK, GMA News