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Hospitals yet to confirm payment of P19-B PhilHealth claims due to cyberattack —Pia Cayetano

Public and private hospitals cannot determine yet if the P19 billion worth of approved PhilHealth claims were already transferred to their accounts due to the recent cyberattack on the state insurer’s system, Senator Pia Cayetano said Wednesday.

At a Senate finance committee hearing, PhilHealth senior vice president for fund management Renato Limsiaco Jr. said that the state insurance corporation has “enough funds” to pay the hospitals, including the P19 billion for the current year as of August 2,2023.

But according to Senator Pia Cayetano, who presided over the hearing, the hospitals cannot verify whether they already received the payments from PhilHealth due to the recent cyberattack.

“Maliwanag naman sa akin na mukha namang desidido ang PhilHealth na bayaran at meron naman silang pambayad. Ang sinasabi nila is dahil nga sa hacking ‘di nila ngayon malaman kung ‘yung ni-release nilang pambayad na P19 billion e nakarating na sa mga account ng private hospitals. Hindi nila tayo ma-assure kasi nga hindi raw nila ma-check kasi naka-down ang system,” Cayetano told reporters.

(It is clear to me that PhilHealth is determined to pay for the claims and they have the funds for it. What they were saying is they cannot confirm whether the released P19 billion was already received by the private hospitals. They cannot assure us because their system is down.)

“Sinabi naman nila approved for payment ang P19 billion pero hindi naman masabi ng mga ospital na natanggap nila ‘yon and no less than the government hospitals represented by the [Health] secretary say na wala pang clarity na natanggap nila yon and ‘yung representative ng private hospital says hindi pa talaga natanggap yon. So sabi ko nasan na? Nasa ere ba?” Cayetano went on.

(They said the P19 billion was already approved but the hospitals cannot say if they have received it already. No less than the government hospitals represented by the Health secretary say that there is no clarity yet as to whether they received it already and even the representative of the private hospitals says they have not received it yet. So I asked them where did the funds go?)

During the same hearing, PhilHealth Executive Vice President and Chief Operating Officer Eli Dino Santos said delays in the payment of claims should be expected as they resort to manual operations due to the cyberattack.

“We are already in the third week since the cyberattack happened. And of course we expect a delay in payment of claims. Because we turned off our system when it happened and the situation at the time was that hospitals could not submit claims. But we implemented over-the-counter processes and procedures. We paid…manually,” Santos said.

PhilHealth was hit by a ransomware attack last month that resulted in the state insurer disabling its systems as part of security containment measures.

While PhilHealth has already brought its system back online, Santos said they are resuming the processing of claims “gradually.”

Right now, the PhilHealth official said there are at least six regions which are already processing claims and they are eyeing the use of the claims processing system in all regions at the end of this week.

Santos also disclosed that PhilHealth had asked President Ferdinand “Bongbong” Marcos Jr. to set up a collective task force that will address the issue of hacking.

“We sent him an official letter. I think Malacañang will be putting that together,” he said.

On the other hand, Cayetano suggested the use of a 60-40 debit-credit system which was also allowed by the Commission on Audit.

“Bakit sila ang mape-penalize dahil nagkaroon ng cyberattack? Sila dapat unang ina-assure niyo. I hate to have to say I don't have to have a hearing to tell you to do that. This is another issue on top of delayed payment issues you have been confronted with for years. Kailangan may plano din ‘di ba,” Cayetano said.

(Why are we going to penalize them because of the cyberattack? They should be the first ones to be assured. I hate to have to say I don’t have to have a hearing to tell you to do that. This is another issue on top of delayed payment issues you have been confronted with for years. You should have a plan, right?)

In response, PhilHealth acting president and chief executive officer Emmanuel Ledesma Jr. said, “We hear you loud and clear. We will comply.”

Cayetano expounded this matter during the interview and said that the cyberattack is also a health security issue.

“It’s a security risk issue na ‘yung mga tao walang mapuntahang ospital, ‘yung mga ospital ayaw tumanggap ng pasyente dahil hindi sila mabayaran,” she said.

(It’s a security risk issue that people cannot access healthcare from hospitals because the hospitals are no longer accepting patients due to the unpaid claims.)

The Senate finance committee conducted a consultative meeting on the issue of unpaid claims with PhilHealth and Private Hospitals Association of the Philippines, Inc. — BM, GMA Integrated News