The Philippine Health Insurance Corporation (PhilHealth) appears to have missed President Rodrigo Duterte’s order to rush the capacity building of the country’s medical facilities to meet the surge in COVID-19 patients.
In a report by the Inter-Agency Task Force to Congress, PhilHealth has only released a token amount of its promised P27 billion funds since the start of the enhance community quarantine on March 17.
IATF said PhilHeath has released P2.501 billion to 65 hospitals as of April 2, or week three of the lockdown in Luzon.
This is less than 10 percent of its allotted P27 billion budget and just one percent of the targeted hospitals.
The funds – equivalent to three months’ worth of claims based on historical data – are meant to give liquidity to accredited hospitals in boosting their capacity to accommodate more coronavirus patients.
PhilHealth said the amount would be charged to the hospitals’ future claims. Hospitals will be asked to submit a letter of intent to avail of the mechanism. This will include including those facing sanctions for various violations of their contracts with the national health insurer.
The arrangement is also part of PhilHealth’s efforts to reduce return-to-hospital payables filed in 2019 and earlier, and to further increase payments to hospitals.
PhilHealth has agreed to should all expenses incurred by members hospitalized due to COVID-19, from testing to hospitalization:
1) COVID-19 or SARS-CoV-2 testing, P8,150 all components covered
2) P5,450 if test kits are donated
3) P2,710 PCR [polymerase chain reaction] testing unbundled for COVID testing
4) community isolation, P22,449 with local government unit overhead
5) mild pneumonia for elderly, P43,997
6) moderate pneumonia, P143,267;
7) severe pneumonia, P333,519
8) critical pneumonia, P786,384.
PhilHealth will cover all COVID-19 tests conducted outside hospitals or in non-hospital facility such as laboratories, provided that the facilities are accredited by the Research Institute for Tropical Medicine (RITM).