MANILA – The House Committee on Health on Tuesday urged the Philippine Health Insurance Corp. (PhilHealth) to review the soundness of its issuances and rectify the "apparent mistake" in its circulars on Covid-19 benefit packages.
This, after the committee adopted House Resolution 1966, urging PhilHealth to immediately rectify and review the issues in its issuances "to ensure just and fair policies for the benefit of the Filipino people".
Quezon Rep. Angelina Tan, who sits as chair of the health panel, particularly raised the issue on PhilHealth’s retroactive application of PhilHealth Circular 2021-008, which was only “circularized” in June 2021 but was subsequently applied in November 2020 or seven months before the official issuance of the circular.
PhilHealth Circular 2021-008 provides that only claims for confirmed Covid-19 cases based on a positive Covid-19 swab test result or RT-PCR test shall be covered by the existing Inpatient Covid-19 Package.
“The retroactive application of the circular removes the probable cases from entitlement under PhilHealth Circular 2020-009, which provides for the same benefits as that of confirmed cases and downgrades the same to an intermediate package," Tan said.
She further argued that this will cause huge losses to hospitals that have already rendered service and processed the claims as well as patients who were already entitled to such claim prior to the issuance of the retroactive circular.
PhilHealth President Atty. Dante Gierran clarified that various modifications made on the benefit packages are not only inevitable but necessary as the state social health insurer needs to continuously review the Covid-19 packages in the face of evolving protocols.
Gierran and other officials, however, admitted PhilHealth’s lapses that resulted in the delay of the issuance of the circular and promised to resolve the infirmity in its policy.
He has also committed to bring the matter to the PhilHealth Board to correct the mistake.
Tan called on PhilHealth Board and leadership to get their acts together and to be more considerate, especially during this time of the pandemic in the midst of hospital closures and threats of the mass walkout of health personnel.
“Millions of Covid-19 probable claims are in danger of being denied as a result of PhilHealth’s turnaround causing huge losses to health care facilities which clinically managed a probable Covid-19 case and eventually causing financial hardship to the Covid-19 patient whose claim will be denied due to fear of prosecution of signatories involved in the approval of the claims,” Tan said. (PNA)
