Senate to PhilHealth: Require immediate liquidation, return of unused IRM by healthcare institutions

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Metro Manila (CNN Philippines, September 1) — Lawmakers are pushing the state-owned health insurer to require healthcare institutions that received allotments under its cash advance program to liquidate used and return unutilized amounts immediately.

Senate President Tito Sotto presented on Tuesday the recommendations of the Senate Committee of the Whole regarding corruption issues of Philippine Health Insurance Corporation officials, one of which is immediate liquidation of utilized Interim Reimbursement Mechanism funds by HCIs, and to return excess amounts.

He noted that PhilHealth should set a definite deadline and to strictly implement it.

Sotto addded that PhilHealth should immediately pay claims of private institutions, priotizing those that are considered COVID-19 referral hospitals and those that have a high number of admissions.

IRM is a prepayment that aims to assist hospitals affected by a “fortuitous event,” in this case the COVID-19 pandemic.

The lawmakers noted that there are inconsistencies in the system, with some private institutions seemingly are being favored by the state-owned health insurer, one of which is B. Braun Avitum Dialysis Center that was reportedly given ₱45 million from April 23 to May 5 despite not having isolation areas and only caters to out-patients.

There is also the case of PhilHealth in Western Visayas that claimed that IRM funds worth ₱521 million were not yet given to their local hospitals even after receiving followup letters.

Senators also questioned the release of funds to HCIs that are not accredited by PhilHealth and still have pending cases, as well as the fast release of funds to hospitals in the regions of Bicol and Eastern Visayas that have low number of COVID-19 cases.

Another issue is the lack of definite guidelines as to how IRM will be liquidated. PhilHealth officials have conflicting memorandum orders issues regarding this, with one deferring fund liquidation, while another allows “optional liquidation.”

Former PhilHealth SVP for legal sector Rodolfo del Rosario Jr. has admitted in a House of Representatives hearing on August 20 that early disbursement from the fund prior to its effectivity in June was illegal.

Deputy Speaker Rodante Marcoleta noted that based on the agency’s circular this will take effect from its publication in a newspaper in general circulation, which was on March 21, and three copies to have been submitted to the Office of the National Administrative Register of the UP Law Center, which was on June 11.

On August 13, PhilHealth suspended the release of the remaining funds pending the review of the system.

As of June 9, total IRM released amounted to ₱14 billion, of which only ₱2.7 billion have been liquidated.