PhilHealth’s P45-B projected COVID-19 claims questioned


A lawmaker questioned Wednesday PhilHealth’s (Philippine Health Insurance Corporation) P45 billion projected claims related to COVID-19, citing it should be lower even if patients were in severe conditions.

PhilHealth acting senior vice president Nerissa Santiago presented in a congressional hearing the P45-billion projection to cover 209,000 COVID-19 cases in the country for 2020.


Santiago said PhilHealth already paid P1 billion for COVID-19 cases claims. As of August 4, the country logged a total of 112,593 confirmed cases.

However, Marikina Representative Stella Luz Quimbo questioned the figures, noting the global data showed only 20% of the cases were admitted to hospitals.

Given this situation, Quimbo said the PhilHealth projection should only be around P3.2 billion, even if all those hospitalized were severe cases.


The lawmaker’s projection is 92.88% lower than the PhilHealth’s projection.

“Hindi po talaga aabot ‘yan ng 45 (billion pesos). Ang worry ko is sa kaka-project ng napakalaki, nagkakaroon ng mas malaking leeway sa fraud na hindi naman maganda,” she explained.

(It will not really reach 45 billion pesos. My worry is that the project is huge. There is a bigger leeway in fraud, which is not good.)

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Senator Panfilo Lacson earlier revealed that PhilHealth gave more than P200 million worth of funds to hospitals treating only one COVID-19 patient each.

Lacson said in a radio interview that one hospital is located in Eastern Visayas, and one is in Bicol. He, however, did not identify the names of the hospitals.

The Senator added PhilHealth released P247 million to Bicol and P196 million to Eastern Visayas in just one week.

Presidential spokesperson Harry Roque on Friday claimed the same report and questioned why PhilHealth allocated P300 million worth of funds to reimburse hospitals in areas with a low number of COVID-19 cases.

PhilHealth officials are currently facing investigation in the Senate over alleged overpriced information and technology (IT) budget.

According to Alejandro Cabading, a certified public accountant and a part of Philhealth’s board of directors, the agency’s initial information and technology (IT) budget for 2020 were P2.1 billion. However, the proposal was rejected after the review showed multiple items were either overpriced or were redundant.