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PhilHealth has accreditation powers: DOJ

By Benjamin Pulta

February 16, 2023, 5:28 pm

<p>Justice Secretary Jesus Crispin Remulla <em>(File photo)</em></p>

Justice Secretary Jesus Crispin Remulla (File photo)

MANILA – State-run Philippine Health Insurance Corp. (PhilHealth) is empowered to choose which health care provider may be accredited under its programs, including whether to restore the revoked accreditation of firms, the Department of Justice (DOJ) said.

In a seven-page legal opinion recently made available, Justice Secretary Jesus Crispin Remulla said “PhilHealth has the discretion to permanently revoke the accreditation of a health care provider or to restore its accreditation, depending on its (PhilHealth) findings and assessment.”

The ruling was furnished to PhilHealth Officer-In-Charge, Atty. Eli Dino Santos, who sought guidance from the DOJ on the extent of the power of PhilHealth to revoke the accreditation of health care providers for offenses under RA No. 7875, the National Health Insurance Act of 1995 and RA 10606 which amended the said law.

Remulla noted that under the said laws, PhilHealth is empowered to prescribe the definitions of specific offenses of health care providers and the rules on preventive suspension, and withdrawal of contract of accreditation.

The DOJ added that the penalty of revocation of accreditation is only imposed to those health care providers which/who are considered recidivists and that “the law explicitly state that recidivists may no longer be accredited or contracted as participants of the program.

“The use of the word ‘may’ makes the provision permissive,” the DOJ said adding that as a consequence the penalty is not mandatory but discretionary and that PhilHealth “may lift the penalty of revocation of accreditation imposed upon the respondent health care provider, if based on its assessment the erring health care provider has already faithfully complied with all its requirements and guidelines.” (PNA)

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