Bato tells PhilHealth: Why are you siding with violators?


Posted at Aug 04 2020 08:55 PM

MANILA - Sen. Ronald "Bato" dela Rosa on Tuesday took the Philippine Health Insurance Corporation (PhilHealth) to task for reversing a Court of Appeals ruling suspending a hospital in Cebu over its patients' extended confinement.

In a Senate hearing on alleged irregularities in the state-run health insurance agency, Dela Rosa quizzed PhilHealth officials for seemingly siding with violators.

"Kaya siguro namimihasa 'yung mga ibang claimants ng PhilHealth na gumawa ng kalokohan dahil very clear na decided na ito ng Court of Appeals, na dapat patawan ninyo ng parusa itong mga hospital na ito, and yet you refused to implement the decision of the Court Appeals. Kaya nag-aabuso itong iba," he said.

"Isipin mo, very clear na 'yung decision ng korte, ayaw pa ninyo i-implement? Ayaw ninyo sundin ang korte? For what reason? You're depriving the Philippines millions of pesos by doing that decision," he added.

Dela Rosa said PhilHealth overturned a ruling that was upheld by the appellate court in Jan. 2019 for a 3-month suspension of Perpetual Succour Hospital in Cebu City. The PhilHealth slapped the hospital instead with a maximum fine of P100,000.

The court's suspension order stemmed from the unjustified extension of confinement of 2 patients despite the issuance of their respective physicians of a “may go home” order. 

In Aug. 2019, lawyer Harry Roque, who is currently spokesman of President Rodrigo Duterte, filed graft charges against former and current officials of PhilHealth in relation to the incident.

PhilHealth senior vice president for legal sector Rodolfo Del Rosario said in Tuesday's hearing that the decision was made by the board in order not to paralyze the country's health services.

"It was a decision by the PhilHealth board of directors based on a policy that was decided even before I was appointed as SVP legal. There was a board resolution to convert decisions, affirmed by higher courts, na kung merong suspension, iko-convert nalang into fine, considering our people need access to health services," he said.

He said the hospital was found guilty of extending confinement of patients of up 2 days, which would only cost PhilHealth some P3,000.

"'Yung rationale nila [board] dito, hindi commensurate doon sa krimen 'yung magiging parusa kasi kung 3 buwan na isu-suspend for an infraction amounting to P3,000, if I'm not mistaken, parang merong inequity. Based on equitable considerations, the board decided to have the penalty converted," Del Rosario said.

Lawyer Jonathan Mangaoang, corporate secretary of PhilHealth's board of directors, said the agency's Committee on Appealed Administrative Cases (CAAC) granted the hospital's appeal because it was the only medical institution in Central Visayas that offered the "Z Benefit Package."

The package includes treatment for prostate cancer, acute lymphocytic leukemia, breast cancer and kidney transplant.

In response, Dela Rosa said, "Ang akin lang, bakit tayo insisting na pagbigyan itong nag-violate, itong violator na ang decision ng Court of Appeals is favorable to PhilHealth? Para bang pinapaboran itong mga nag-violate."

During the hearing, Sen. Panfilo "Ping" Lacson bared that he received a letter from the hospital saying they were told they could file an appeal with the agency's new board.

And he noted that some PhilHealth officials were found to have traveled to London after allegedly overturning the CA ruling.

"Kayo pa pala 'yung nag-encourage sa kanila na mag-appeal. Very detrimental on the part of the government 'yung ginagawa ninyo. Kaya naubos ang pera ng PhilHealth dahil sa katarantaduhan ninyo," Dela Rosa said.