Davao City Hospital Receives Biggest Cash Advance From PhilHealth

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PhilHealth Inquiry: Senate President Vicente C. Sotto III, Tuesday August 11, 2020, calls for the resumption of the second hearing of the Plenary Committee on Senate Resolutions calling for an investigation for the benefit of corruption and bad legislation Widespread management reported in the PhilHealth. Also pictured (left) Senator Francis “Tol” Tolentino and (right) Senator Panfilo Lacson. (Joseph Vidal / PRIB Senate)

MANILA, Philippines— Weeks before approving guidelines for using special funds for the government’s response to COVID-19, Philippine Health Insurance Corp. (PhilHealth) had already distributed 9.3 billion pesos in cash advances to various hospitals, especially facilities, Senator Panfilo Lacson revealed on Tuesday.

As the Senate hearing resumed into the corruption scandal plaguing the state-run health insurer, PhilHealth officials said that a Davao city hospital was the largest recipient of funds from the Interim Repayment Mechanism (MRI) of 30 billion pesos.

The Southern Philippines Medical Center, a public hospital in the hometown of President Rodrigo Duterte, received 326 million pesos. The University of the Philippines-Philippines General Hospital in Manila, a major referral hospital for COVID-19 patients, has received an advance payment of 262.3 million pula.

Another hospital in the Davao area, the Davao Regional Medical Center in Tagum City, came third, getting 209 million pesos. Lacson, Senate President Vicente Sotto III and other senators have pounced on the questionable distribution of MRI allocations, which have been specifically allocated to hospitals treating patients infected with the new coronavirus.

Lacson said a review of PhilHealth records showed a “pattern” that some hospitals, especially private ones, were favored in distributing MRIs over public hospitals. For example, he said Eastern Governor Samar Ben Evardone complained about the delay in reimbursing P24 million claims for benefits from at least 10 district hospitals in the province.

“There is a model here. Why is this happening? There seems to be favoritism in the choice… of private hospitals to receive MRI funds, ”Lacson said.

Senator Joel Villanueva said the prompt release of 45 million pesos in cash advances to B. Braun Avitum Philippines despite pending cases from the dialysis center at PhilHealth proved that the insurer had given preferential treatment to some facilities. health.

“I don’t think there is any doubt that there is patronage in PhilHealth,” Villanueva said.

“MRI has now become an ‘Unfair Reimbursement Mechanism’. It is used by PhilHealth for the benefit of certain “blessed” (hospitals), “he said during the nine o’clock hearing.

Lacson said records showed B. Braun was not even registered with the Securities and Exchange Commission.

“Are you not doing your due diligence? You free up millions of pesos, ”Lacson said. “You have paid advances to B. Braun, who charges their patients for dialysis. So where did the money you gave go? “

Thorrsson Montes Keith, who had resigned as PhilHealth’s anti-fraud legal adviser, said he suspected PhilHealth senior vice president Rodolfo del Rosario of actually owning B. Braun, based on deposits made in a rural bank in Balanga, Bataan province, which the head of PhilHealth is said to have frequented. .

Del Rosario has denied owning the dialysis center.

bailiwick LP

Senatorial Minority Leader Franklin Drilon also lamented that requests for MRI funds from 33 hospitals in his home region of the Western Visayas, considered the bailiwick of the opposition Liberal Party, have not been granted by PhilHealth since April 6.

“So far not a single peso has been released at these 33 hospitals,” Drilon said. But PhilHealth legal counsel Robert Labe Jr. insisted all versions of IRM comply with existing PhilHealth regulations.

“MRI is not provided arbitrarily. There is a process that is followed, ”he said.

Sotto, who led the investigation with Lacson, questioned PhilHealth President and CEO Ricardo Morales about the IRM’s legal basis that would justify distributing billions of pesos in cash advances to credit institutions. public and private health.

Morales, who joined the hearing via the Internet, said Republic Law 7875, the law that created PhilHealth, allowed him to “oversee the provision of health benefits … and establish the standards, rules and regulations necessary to ensure the quality “of health care in the country.

But Sotto said the concept of a “payment mechanism” as spelled out in the law was different from the “financial mechanism” that PhilHealth’s board of directors cited when creating IRM.

“Does PhilHealth have the power to fund a (hospital)? It’s not included in your mandate, is it? Sotto asked the head of PhilHealth. Morales agreed, adding that the authority of the company was to pay for health services.

Anticipate the Covid-19

Morales claimed that PhilHealth’s board of directors began discussions about creating the MRI as early as January in anticipation of the effects of COVID-19.

“We were in a state of anxiety (then) because we knew COVID-19 was coming,” Morales said. “We wanted to take preventive measures to be able to prepare our hospitals to respond to this pandemic. “

Lacson and Drilon criticized Morales for claiming PhilHealth came up with the idea for the MRI in January. Drilon pointed out that Health Secretary Francisco Duque III told the public in early March that he did not need to worry.

PhilHealth board member Alejandro Cabading and Dr Susan Mercado, who recently resigned from the board, have denied Morales’ statement.

“As far as I can remember, we weren’t talking about COVID-19 (at that time),” Mercado said, adding that it was not the board that initially allocated 27 billion pesos to IRM.

Responding to Lacson’s questions, Mercado said the PhilHealth board was just “informed and invited to approve” PhilHealth Circular No. 2020-0007, which Morales is said to have signed on March 20.

Backdated resolution At the time, Lacson said, official PhilHealth records showed the company had already released 703 million pesos. Showing another set of documents, the senator said the resolution was “backdated” because it was not finalized until April 22, more than a month after health insurance started disbursing funds from MRI.

Lacson said PhilHealth’s MRI distribution had already swelled to 9.3 billion pesos by then. Worse, PhilHealth did not pass board resolution 2515 until March 31, which was necessary to justify the March 20 circular, according to the senator.

“So what were the guidelines (used by) the regional vice presidents when issuing ITNs when the guidelines, called SOPs (standard operating procedures), were not released until after (funds were distributed)? asked Lacson.

“Some expedients”

In response, Morales explained, “In administering our efforts, certain expedients had to be adopted because we did not know the possible impact of COVID-19. “

“We had to release the funds immediately. But we made sure that all outings were covered by a contract and that we would be able to account for all the funds that were (made) available, ”he added.

Lacson wondered why the cart came before the oxen. “The resolution (of the council) is the one that should pull the cart,” he told Morales.

1000 P for false patients

Senate Majority Leader Juan Miguel Zubiri said PhilHealth investigators informed him that many unscrupulous hospitals were not only involved in the ‘turnaround’ of treatment, but were also behind the treatment. “non-existent patients” and discount programs.

Zubiri said the hospitals would have paid 1,000 pesos each to “act” as patients, who were entitled to reimbursements from the health insurer. “Some (hospitals) pay people 1000P to act as patients in order to (collect benefits) more serious illness claims from PhilHealth,” he said.

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