P14B to 711 health care facilities, says Philhealth

·3 min read

THE Philippine Health Insurance Corp. (Philhealth) has released P14.97 billion to 711 health care facilities nationwide under the Interim Reimbursement Mechanism (IRM) as of July 31, 2020.

And of this amount, P13.03 billion or 87 percent of the IRM released has been liquidated as of Dec. 13, 2020, the PhilHeath 7 announced on its Facebook page Monday, Jan. 4, 2021.

The Facebook post came with the introduction: “Properly accounted for: Ang IRM wala gibulsa. Gi-release kini ngadto sa mga accredited nga health care institution (HCI) o mga ospital/pasilidad aron magamit sa mga pasyente. Padayon kini nga gi-liquidate sa mga mga HCIs.” (The IRM was not pocketed. It was released to the accredited HCIs or hospitals/facilities for use by the patients. The HCIs continue to liquidate the funds.)

The Interim Reimbursement Mechanism (IRM) is a measure applied by PhilHealth to provide health care institutions (HCIs) with emergency funds during unforeseen events like natural disasters, calamities and other fortuitous events. This mechanism was previously tapped to respond to disasters that ravaged parts of the country such as that experienced during typhoons Ondoy and Yolanda, and recently with the Taal Volcano eruption.

To prepare for a coordinated response to the Covid-19 pandemic that started to unfold in March 2020, HCIs including dialysis centers and lying-in clinics nationwide were allowed to apply for IRM equivalent to their three months’ worth of benefit claims in 2019. HCIs can opt to avail of the full three months’ limit as computed or a portion thereof.

Of the 711 health care facilities that received the IRM funds, 353 had fully liquidated the funds, 273 facilities had liquidated at least 50 percent of the funds, while 85 facilities had liquidated less than 50 percent of the funds they had received.

Liquidation of the IRM is by submission of a report to PhilHealth on the claims for patients that HCIs have attended to during the period.

In late May 2020, recognizing the clustering of Covid-19 cases in NCR, Regions 3 (Central Luzon), 4-A (Calabarzon), 4-B (Mimaropa), and 7 (Central Luzon), PhilHealth revised its strategy by scaling down releases only to these areas.

The presence of referral facilities for Covid-19 patients was also identified as a factor for targeted IRM releases. This was to ensure that sufficient funds were available for all citizens needing healthcare as well as guarantee sufficient support to the country’s expanded targeted testing strategy.

Central Visayas--which groups Cebu, Bohol, Oriental Negros and Siquijor--received P1.1 billion of the P14.97 billion in IRM funds released nationwide, of which the region had liquidated P691.8 million.

Dividing the Philippines into 20 regions, PhilHealth listed the top IRM recipient as National Capital Region (NCR) Central, which received P1.93 billion; followed by NCR North, P1.38 billion; Calabarzon, nearly P1.25 billion; Central Visayas, P1.10 billion; and Region 3-A, nearly P1.08 billion.

The other regions in the top 10 were NCR South, P1.04 billion; Region 11 (Davao Region), P890 million; Region 3-B; P877 million; Region 1 (Ilocos Region), P782.5 million; and Region 10 (Northern Mindanao), P737.8 million.

Last year, the state insurer was rocked by allegations of corruption by then anti-legal fraud officer Thorsson Keith, who alleged that P15 billion of PhilHealth’s funds had been pocketed by corrupt members of the PhilHealth “mafia." (CTL, PR)