SENATE President Pro-Tempore Ralph Recto lambasted Wednesday private entities that are receiving two-thirds of the Philippine Health Insurance Corp.'s (PhilHealth) P78-billion fund.
Recto, at a Senate joint hearing on the PhilHealth scam, said the huge chunk given to the “erring" private health care providers resulted in the poor maintenance of the country’s public hospitals.
“Why are private hospitals benefiting more (than the public hospitals? It would appear that two-thirds of P78-billion (fund of PhilHealth) went to private hospitals and not public hospitals,” Recto said.
“Giving a huge amount to private hospitals is the reason why public hospitals cannot improve their facilities,” he added.
Recto then urged PhilHealth to probe deeper into the fraudulent payments it made to private clinics and hospitals to find out if individuals inside the agency are helping the recipients of multi-million-peso reimbursements.
He also pushed for heavier penalties against state workers or PhilHealth employees who invent insurance claims.
PhilHealth president Alexander Padilla, however, assured that employees of the agency were not involved in the issue.
“There may be possibility (that PhilHealth employee are behind this scam) but in this particular case, all the money went to private health care institutions unless there will be allegation (but) I don’t hear a specific individual or person involved. Not with this,” Padilla said.
Apparently unconvinced by Padilla's statement, Recto said the Commission on Audit (COA) must review some of the claims to dispel all doubts.
He said all PhilHealth reimbursements went to the private sector and claims applied for by them were acted somewhat “expeditiously” by the agency.
“Why is the processing too fast if (the one applying) are private eye centers? But when it comes to government hospitals, it seemed too slow,” Recto said, citing applications by public hospitals in Batangas whose approval “could have been done in a faster manner."
“Isn’t it a tell-tale sign that there are really expediters inside the PhilHealth?” he added.
Recto noted that payouts involving indigents, at P25 billion last year, was smaller than the P37 billion that government shelled out in premium cost for indigents it enrolled in PhilHealth during the same year.
With that, he said PhilHealth must step up its information campaign so those who are covered but are unaware would be informed that they have medical insurance.
He cited the case of the recent law granting automatic coverage to citizens 60 years old and above, “good news which has yet to attain a 100-percent awareness level on its supposed beneficiaries.”
Recto said stiffer fines must be imposed to avert scams in the PhilHealth fund.
“What’s being stolen here is taxpayer’s money and what is stolen from pool reduces the resources which can be given to deserving claimants,” he said.
To date, a doctor who violates Republic Act 10606 or the PhilHealth Act may be fined up to P50,000 to P100,000.
A hospital, on the other hand, will have to pay a fine of P50,000 to P100,000 plus a suspension or revocation of PhilHealth accreditation. (Sunnex)