STATE-OWNED Philippine Health Insurance Corporation (PhilHealth) has released interim refund mechanism (IRM) funds amounting to P1.49 billion to 51 healthcare institutions with pending fraud cases, a legislator said Monday, August 17, 2020.
Citing a PhilHealth report, House committee on public accounts chairperson Mike Defensor said the fraud cases against the 51 institutions should have been resolved first.
"Itong 51 hospitals na ito ay may fraud cases na binigyan ng IRM--mayroong nakita ako isa o dalawa, katulad nung St. Luke's, Medical City. So ang pinagtataka ko, bakit hindi ni-resolve ang fraud cases bago nag-release ng IRM?" Defensor asked
"Kasi sa mata ng publiko, kung ganito na nga na may fraud cases ang mga ospital at institusyon tapos bibigyan pa rin ng pondo ng PhilHealth, nakakatakot itong batayan at ehemplo," he said.
In its report posted on its website on August 10, PhilHealth said it has released more than P14.9 billion in IRM funds to healthcare institutions.
The IRM provides health care institutions with emergency funds during natural disasters and other fortuitous events.
To prepare for the coronavirus disease 2019 (Covid-19) pandemic, healthcare institutions were allowed to apply for IRM funds equivalent to 90 days of benefit claims in 2019.
According to Defensor, 4,664 fraud cases have been filed against hospitals from 2013 to 2020.
Of the total, 768 were reported from 2013 to 2018 and 3,806 were from 2019 to 2020.
Offenses include padding of claims, post-dating of claims, misrepresentation by furnishing false or incorrect information, fabrication or possession of fabricated forms, and supporting documents.
PhilHealth earlier said the IRM funds ensure that its members receive regular Covid-19 in-patient benefits, testing and community isolation packages.
Senate Minority Leader Franklin Drilon had called for the abolition of the IRM, saying the agency could still support Covid-19 patients without it.
He said PhilHealth should instead improve its system and reimburse the hospitals on time. (Jove Moya/VoxPop Philippines)