By Joseph B.A. Marzan and Jennifer P. Rendon
Private hospitals in Iloilo City on Friday, December 10, made true of their promise back in September 2021 that they would not renew their accreditation with the Philippine Health Insurance Corporation (PhilHealth) starting January 1, 2022.
The heads of seven private hospitals – St. Paul’s Hospital, Iloilo Doctors Hospital, Iloilo Mission Hospital, The Medical City Iloilo, Medicus Medical Center, Qualimed Hospital, Iloilo and Metro Iloilo Hospital and Medical Center Inc. – formalized their plan to disengage from PhilHealth in a letter sent to the office of Iloilo City Mayor Jerry Treñas on Friday.
“We respectfully inform you that in our meeting Dec. 9, we, the undersigned seven private hospitals in the City of Iloilo decided not to renew our accreditation with the Philippine Health Insurance Corp. (PHIC) starting Jan. 1, 2022,” the letter stated.
In the letter, the hospitals cited PhilHealth’s unpaid claims totaling P545 million as of Aug. 31, 2021.
The letter also stated that while PhilHealth acted on the request to process the claims on Oct. 8, the state-run insurer only paid 15 to 20 percent of what was owed to them.
“A reconciliation process aimed to pay off the accounts receivables was initiated by PHIC only last October 8, 2021, upon our demands and payment should be done by October 31, 2021. The results of this endeavor only accounted for 15-20% payment of the total accounts receivables ending August 31, 2021. Another set of accounts receivables piled up from September to November 2021,” the concerned hospitals noted.
They said that the lack of response from the PhilHealth, as well as the lack of equity in their accounting of the claims, was “the last straw for them”.
“It is therefore clear that [PhilHealth] cannot comply with its obligations. We can see that we will be facing the same scenario in the future as what we had experienced prior, if [PhilHealth] will not comply with its legal obligations to us under Republic Act 7875 [The National Health Insurance Act], as amended,” the hospitals said in their letter.
“We are greatly saddened by this action we have to take. However, we are left with no other choice but to ensure the survival of our hospitals so that we can uphold our commitment to offer necessary and quality healthcare to our patients,” they added.
They committed, however, that they would continue to serve PhilHealth members and provide statements of accounts for reimbursement and remit employee contributions, but will no longer automatically deduct and process claims.
“Our hospitals will still remain open and we will continue to serve PhilHealth members. However, we will no longer deduct PhilHealth benefits and process (sic) claims. We will provide the necessary statement of accounts for their reimbursement and will faithfully remit the [PhilHealth] contributions of our employees,” they added.
Copies of the letter were also sent to PhilHealth, Department of Health, Private Hospitals Association of the Philippines, Inc. and Philippine Hospital Association.
One of the hospital chiefs, Dr. Danilo Encarnacion of the Metro Iloilo Hospital and Medical Center said in September that they were already mulling the non-renewal.
Treñas had also sued PhilHealth in relation to COVID-related claims owed to the hospitals in that same month totaling P932 million.
The complaint stemmed from alleged “uncatered, unheeded, and unpaid COVID-19- related claims of hospitals amounting to P932,322,324.35, as of August 24, 2021.”
Dated Aug 26, the complaint was addressed to Deputy Ombudsman Paul Elmer M. Clemente of the Office of the Deputy Ombudsman for the Visayas and Secretary Jeremiah B. Belgica, Director General of the Anti-Red Tape Authority.
The filing of the case was intended “for the early payment of the claims of the hospitals in the city and the Uswag Molecular Laboratory.”
It was on Aug 25 when Treñas announced his plan to file a case against PhilHealth-Region 6 officials. A week after that, he said that the Iloilo City Council has already authorized him to file the complaint.
In his letter complaint, Treñas noted that the claims were already elevated to Atty. Dante Gieran, PhilHealth President and chief executive officer, on June 24, 2021.
It was further reiterated in yet another letter on Aug 24, 2021.
“In both communications, the urgency of releasing the PhilHealth claims, vis-à-vis the need for sustaining the health care system of Iloilo City amidst the alarming COVID-19 situation has been stressed and reiterated,” Treñas said.
However, “up to this day, our pleas have called to dead ears,” he said.
Immediately after the mayor signed the complaint, PhilHealth-Region 6 issued an official statement relative to Treñas’ move.
Atty. Valerie Hollero, Philhealth Regional Vice President for Western Visayas, said that she is saddened that Treñas has resorted to filing a complaint against them.
“I feel bad for the 402 hardworking employees of PhilHealth Regional Office VI who have worked so hard to process good claims immediately in order to help our partner hospitals at this time of pandemic,” she said.
She stressed that PhilHealth-6 was, in fact, one of the fastest offices to process claims.
“As shown during the congressional hearing on PhilHealth’s Unpaid Hospital Claims this afternoon, PhilHealth Region VI has a turnaround time of 27 days and has the highest number of claims processed per employee nationwide at 1,255 a month. I urge my colleagues not to be disheartened. As public servants, we have sworn to serve our country, whatever the cost. Padayon lang,” she said.
Even earlier, Treñas has already doubted PhilHealth’s financial robustness.
“PhilHealth is no longer capable of paying the claims. In Iloilo City alone, the claims are reaching almost P1-B.”
The mayor has also retorted PhilHealth-6’s claims that they posted the most number of claims processed per employee.
If indeed such was true, “others would be in a more pitiable state. If we are on verge of drowning, others might have already drowned,” he said in vernacular.
Treñas has earlier said that the health system in the country will collapse in case nothing is done about this.
He noted that there must be some urgency in the payment of these claims “unless we want the health care system to collapse.”
