House panel to probe PhilHealth’s P14-B IRM cash advances to hospitals

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A House committee investigating the alleged irregularities at would examine the agency’s P14-billion  Interim Reimbursement Mechanism () advance payments to hospitals for COVID-19 patients “for any sign of fraud.”

“We will examine those payments in detail for any sign of fraud and/or overpayment,” said Anakalusugan Representative Mike Defensor, chair of the public accounts committee, Friday.

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“We have already asked PhilHealth to submit all supporting documents,” he added.

Defensor was pertaining to the controversial IRM. Officials learned during a Senate hearing that a huge chunk of the said funds was given to dialysis centers and hospitals where there is low to no high number of COVID-19 cases.

Commission on Audit’s (COA) records showed PhilHealth only liquidated P1 billion of the P14 billion IRM fund it released amid the COVID-19 crisis.

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“We hope to get the supporting papers next week. These should indicate the amounts advanced, the recipient-hospitals, amounts liquidated, number and classification of new coronavirus disease cases, number and names of patients, medicines given, and the treatment patients received,” Defensor said.

The state insurer earlier released the adjusted package rates for COVID-19 cases:

  • P43,997 for mild pneumonia
  • P143,267 for moderate pneumonia
  • P333,519 for severe pneumonia and
  • P786,384 for critical pneumonia/coronavirus disease.

PhilHealth’s IRM controversy

Former anti-fraud legal officer Thorrsson Montes Keith claimed PhilHealth president and CEO Ricardo Morales of being a “coddler or (who) may have become the new leader of a syndicate in PhilHealth” for permitting IRM implementation.

Morales, however, defended the adoption of Interim Reimbursement Mechanism, saying it is a necessary response for the COVID-19 pandemic.

PhilHealth, meanwhile, announced it suspended the implementation of its  (IRM) amid the investigation on alleged anomalies in the state insurer.

PhilHealth posted on its official Twitter account Wednesday night the suspension of IRM.

According to PhilHealth, the suspension would allow it to “review and resolve” issues arising from the ongoing probe in Congress.

The agency vowed to find measures to make the IRM more responsive to the needs of healthcare facilities hit by the COVID-19 crisis.

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