Metro Manila (CNN Philippines, May 30) — The Philippine Health Insurance Corporation plans to file libel charges against the head of a private hospitals’ group who accused the state insurer of delayed payments detrimental to the operations of some health facilities.
“PhilHealth categorically denies as unfounded, malicious and irresponsible the statement made by Dr. Rustico Jimenez that 300 or so private hospitals are facing closure due to delayed payments by PhilHealth,” the agency said in a statement on Saturday.
Jimenez, president of the Private Hospitals Association of the Philippines Inc., said in a television interview that around half of its member hospitals are about to close due to many factors, including “the much delayed payment from PhilHealth.”
PhilHealth said it disbursed a total of ₱52.53 billion worth of claims and reimbursements from January 1 to May 29. Of this amount, ₱38.6 billion was for payment of claims, more than half or ₱21.8 billion of which went to private hospitals.
PhilHealth said it included ₱4.74 billion paid under its accelerated Return to Hospital initiative. The remaining ₱13.93 billion was released under its interim reimbursement mechanism.
PhilHealth admitted, however, that there was an “increase in turn around time… due to adjustments for the COVID-19 pandemic.”
“Claims reimbursements were processed at an average turnaround time of 41 days with a denial rate of 2%,” it said.
PhilHealth stressed that it earlier explained the purpose of reconfiguring its interim reimbursement mechanism program, and clarified that there was “no promise” advance payouts will be given to all hospitals.
“This was a misinterpretation of Dr. Jimenez,” PhilHealth said, slamming the doctor for his “historical pattern of wild and unfounded accusations.”
“PhilHealth’s Legal Department is now exploring filing libel charges against Dr. Jimenez at the same time its regional staff continues to work directly with all its hospital partners to resolve the issue of account reconciliation,” PhilHealth said.
PhilHealth covered all costs for treatment of COVID-19 patients from February 1 until April 14. It now has rates of coverage depending on the severity of illness.
