SPMC defends P336-M advance funding from PhilHealth; insurance firm suspends IRM

ABS-CBN News

Posted at Aug 13 2020 06:16 PM | Updated as of Aug 13 2020 06:41 PM

MANILA - The Southern Philippines Medical Center (SPMC) on Thursday defended the Philippine Health Insurance Corp's (PhilHealth) disbursement of some P336 million in advance deposit to it, a mechanism suspended on the same day by the state health insurer amid scrutiny by lawmakers.

PhilHealth announced on its official Twitter account the "suspension of the Interim Reimbursement Mechanism (IRM) to review its overall implementation and resolve issues arising from Congressional inquiries."

Senators earlier noted that the IRM was only intended to cover the COVID-19-related expenses of hospitals as the prepositioning of funds is only allowed for specific "fortuitous" events like the global pandemic.

The SPMC received P336 million when there were only 1,572 COVID-19 cases in the Davao region, while the University of the Philippines-Philippine General Hospital - which administers and processes COVID-19 tests in virus epicenter Metro Manila - only got P263.3 million, former Kabataan Party-list Rep. Terry Ridon said.

The SPMC "is catering the whole Mindanao," its officer in charge Dr. Ricardo Audan told ABS-CBN News on Thursday, noting that the Davao City-based hospital has been the top recipient of PhilHealth reimbursements such as in the years 2007 and 2015.

"Ang SPMC, one-stop shop for the diseases... We are the largest, the biggest hospital in the Philippines," Audan said.

PhilHealth Acting Regional Vice President for Davao Hector Zenon Leonardo Malate gave a similar explanation, saying SPMC is a hospital with a 1,500-bed capacity that caters to "patient-referrals from all other regions outside Davao."

"We vehemently deny allegations of favoritism on IRM releases or corruption in the region," Malate's said in a statement, referring to PhilHealth's interim reimbursement mechanism.

"The amount of IRM funds released to SPMC was based on the hospital's 90 days annual historical benefit claim and have undergone due process," his statement reads.

PhilHeallth SVP for Finance Israel Pargas and Health Undersecretary Maria Rosario Vergeire also said Wednesday that the IRM for hospitals is based on past figures, instead of the current need of hospitals.

PhilHealth officials, including Davao region's Malate, said that the IRM "is not solely intended for COVID-19 treatments," but could also be used for "all health care services such as dialysis, chemotherapy and maternity benefits."

Senators earlier accused PhilHealth of disbursing large advance payments to "favored" hospitals, while clinics in regions "perceived as enemies" are denied of timely or adequate reimbursements.

PhilHealth officials have denied the allegations.

In suspending the IRM, the PhilHealth said it vows to find ways to make it "more responsive to the needs of healthcare facilities affected by the current pandemic to assure patients of continuous access to needed health services."

The Presidential Anti-Corruption Commission has summoned hospitals tagged in the alleged anomalies in the state-run insurance firm, after President Rodrigo Duterte warned corrupt PhilHealth officials that they would be weeded out from the agency.

The Davao Regional Medical Center in Tagum City received the third biggest chunk of the IRM at P209 million, while the Vicente Sotto Memorial Medical Center in Cebu City got P204 million, data from PhilHealth showed.

 

- reports from Chrislen Bulosan and Katrina Domingo, ABS-CBN News