THE Philippine Health Insurance Corporation (PhilHealth) has denied the motion for reconsideration to re-accredit the Bacolod Our Lady of Mercy Specialty Hospital (BOLMSH), as it stressed it has nothing to do with the hospital closure.
In a statement, PhilHealth said the closure of BOLMSH is a decision that was made by its own management and not by PhilHealth or of the government.
"It can continue to exist and operate to serve its local constituencies and for the welfare of its employees if it wants to, even without its accreditation with PhilHealth," it said.
PhilHealth said the denial of the hospital's application for continuous accreditation filed on January 30 stemmed from the fact that the hospital has been convicted twice for committing fraudulent acts, which involve padding of claims, misrepresentation by furnishing false or incorrect information, and breach of warranties of accreditation/performance commitment as provided for in Sections 154, 158 and 164, respectively, in the Revised Implementing Rules and Regulations (RIRR) of Republic Act 7875.
Local reports have alleged that PhilHealth had committed an error by attributing these convictions committed by its former management, Tiong Bi Inc., with the current Management Negros Healthcare Management Systems Inc. (NHMSI).
Regardless, if such violations are of the old or of the new management, Section 63.d of the same RIRR clearly stated that "change in ownership, management or any form of transfer either by lease, mortgage, or any other transfer of a health care institution without prior notice to the Corporation" is enough ground for PhilHealth to uphold the decision of its Accreditation Committee, the statement said.
The said Committee is a collegial body that is made up of PhilHealth, Department of Health, Philippine Hospital Association, and Philippine Medical Association, and its decision on the issue went through a diligent process in accordance to RA 7875.
The hospital through its new management cannot evade liability on the ground that the violations were committed by previous management, PhilHealth said.
Once health care institutions partner with PhilHealth for the implementation of the National Health Insurance Program, they commit to abide by the policies that PhilHealth institutes and any violation of this commitment may be considered as grounds for the non-renewal of their accreditation, it added.
It also said that the public has the right to know that the BOLMSH appeared to have tried deceiving PhilHealth when it submitted its application for continuing accreditation on January 30, with Dr. Jeremias Manuel Moscardon Jr. as medical director, Tiong Bi Inc. as owner, and managed by NHMSI.
On February 7, another hospital by the name of Holy Mother of Mercy Hospital in Kabankalan in Negros Occidental also submitted its application for continuous accreditation with the same medical director and this time with NHMSI as owner.
"Your PhilHealth is duty bound to ensure that the National Health Insurance Program and the millions of Filipinos who rely on the program for their health insurance needs are protected from unlawful and fraudulent deeds of both its implementers and beneficiaries," the statement said.
With the best interest of the Filipino in mind, PhilHealth ensures to continue to work for the fund's long-term strength and viability and to continuously grant financial access to quality medical care from its partner health care providers, it added.
The hospital management could not be reached for comment as of press time Thursday, August 2.
Due to the shutdown of hospital operations on July 31, 401 workers were affected.
In a related development, Bacolod City Representative Greg Gasataya said it is very unfortunate that this happened to BOLMSH.
"The management of the hospital now has been claiming that they are not to be blamed for the previous lapses because they were not it, but it just happened that the name is the same which is the legal point of view. I don't know if there is still an appeal to be made in consideration of the patients and the employees who lost their jobs," Gasataya said.
He also said he will discuss with Bacolod City Mayor Evelio Leonardia what help they could possibly extend to the hospital.
