THE Philippine Health Insurance Corp. (PhilHealth) has expanded the coverage period of the suspended Single Period of Confinement (SPC) policy.
Based on its Circular No. 2025-0015, PhilHealth said the SPC is now retroactively lifted from the period of February 20, 2019, instead of October 1, 2024.
"The PhilHealth Board is expanding the applicability of the lifted SPC rule to denied claims with pending protest or appeal with the PhilHealth Regional Office Claims Review Committees (PRO-CRCs) or Protests and Appeals Review Department (PARD) with re-admissions starting February 20, 2019," said PhilHealth.
"Covering readmissions starting February 20, 2019, if such claims were denied solely due to SPC rule, the restriction shall be lifted, and the claims shall be processed following standard benefit availment guidelines," it added.
PhilHealth said the lifting of the policy shall continue to be in effect on all case rates.
"This policy shall be applicable to all medical conditions and surgical procedures," said PhilHealth.
The Single Period of Confinement is a policy developed during the "Philippine Medicare era," and has led to denial of claims for readmissions for the same condition within a 90-day period.
The said policy has caused financial losses to hospitals and other health facilities, as well as increased out-of-pocket spending for patients.
In late2024, the PhilHealth lifted the SPC rule and took effect beginning October 1, 2024. (Anton Banal/SunStar Philippines)
