PhilHealth’s P45-B claims for COVID-19 questioned by Congress

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Congress on Wednesday has questioned Philippine Health Insurance Corporation’s (PhilHealth’s) planned release of P45 billion for claims related to COVID-19.

A lawmaker  countered that this should be lower even if patients are diagnosed with severe cases.

PhilHealth acting senior vice president Nerissa Santiago said the state insurer expects the P45-billion projection to cover 209,000 cases of COVID-19 in the Philippines this year.

Such projections were considered by PhilHealth when it said its actuarial life is now down to a year, from 10 years in 2019, along with the expected decline in collections.

Santiago also said  that only around P1 billion has been paid for COVID cases so far.

Latest data indicates that as of Auguust 4, 2020, the Philippines has recorded a total of  112,593 confirmed cases.

However, Marikina Representative Stella Luz Quimbo noted that under global data, only 20 percent of the cases are hospitalized.

Taking this into consideration, Quimbo said that the PhilHealth projection should only be around P3.2 billion, even if all those hospitalized are severe cases which would incur the highest costs.

Quimbo’s projection is 92.88 percent  lower than PhilHealth’s P45-billion 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.

Quimbo  cited  that presidential spokesperson Harry Roque, Jr. himself said most of the COVID-19 cases in the Philippines are mild or asymptomatic

PhilHealth is now facing investigations after three officials resigned just last month over alleged corrupt practices in the agency.

One of them was anti-fraud legal officer Thorrsson Montes Keith, who in a Senate hearing on Tuesday said the PhilHealth “mafia” has pocketed some P15 billion from fraudulent schemes.

Roque also said PhilHealth officials are under investigation over the agency’s alleged overpriced purchase of an information technology system worth over P2 billion.
Roque said the investigation will be headed by Undersecretary Jesus Melchor Quitain of the Office of the Special Assistant to the President./Stacy Ang

 

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