SENATE TO LOOK INTO PHILHEALTH SAFEGUARD MECHANISMS – CHIZ

Sen. Francis Escudero said the Senate will look into the safeguard mechanisms in place at the Philippine Health Insurance Corp. (PhilHealth), which receives one of the biggest chunks of public spending for health.

He said he wants to ensure that government allocation for the health coverage of the poor would not go to scammers.

“Titingnan namin yung check and balance, yung safeguard mechanisms ng Philhealth dahil ito ay matagal nang nangyayari kahit sa ibang bansa,” Escudero told reporters.

“Kahit sa Medicare ng Amerika, matagal na nilang ginagawa rin iyon pero may nakakalusot pa rin. Isang bagay ito na dapat maging mulat ang Philhealth. Isang bagay ito na dapat maging conscious sila,” he said.

In 2014, the government earmarked P35 billion for PhilHealth premiums to cover 15 million indigents in the Philippines. It was a 179-percent increase in government health subsidy for the poor.

For this year, over P36 billion has been set for premium payments of indigents.

“Ang pondo kasi sa PhilHealth na nilalaan natin ay pambayad sa premium ng mga beneficiaries. Hindi naman ito pondo para sa pagpapatakbo ng PhilHealth,” said Escudero, who chairs the Senate finance committee.

Some 90 million Filipinos are enrolled in PhilHealth. Of this, 43 million are indigent members and their dependents.

Escudero said the recent scams uncovered by the PhilHealth should not stop the agency from approving claims for cataract surgeries.

Cataract removal is the 5th most common procedure reimbursed by PhilHealth in 2014, accounting for 128,331 paid that amounted to P2,056,379,782.

“Huwag naman porke’t may anomalyang ganyan, titigil na nila lahat ng operasyon sa katarata ng mga beneficiaries at members nila,” Escudero said.

PhilHealth just needs to be thorough about validating claims, he said.

Last year, the PhilHealth made a total of P78 billion in benefit payments, 23 percent of which went to private hospitals and clinics.

On July 1, the Senate began its inquiry into the reported P2 billion suspicious claims of hospitals and clinics accredited by PhilHealth, many of them for cataract removal procedures.