PHAPi to new admin: Pick PhilHealth chief who understands situation of hospitals, beneficiaries

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Metro Manila (CNN Philippines, June 27) — The new administration should select someone who understands the state of hospitals and beneficiaries as the head of the country’s health insurer, a private hospitals group said on Monday.

Ang aming hinihiling, na sa bagong pamunuan, itong ibibigay nila na presidente o pangulo ng PhilHealth (Philippine Health Insurance Corp.) ay ‘yun talagang nauunawaan ang kalagayan ng ating mga hospitals at, of course, ‘yung ating mga beneficiaries,” Dr. Jose de Grano, president of the Private Hospitals Association of the Philippines, Inc., told CNN Philippines’ Newsroom Ngayon.

[Translation: We’re asking the new administration to choose a PhilHealth president who really understands the situation of hospitals and, of course, the beneficiaries.]

At the height of the COVID-19 pandemic, the health insurer faced a backlash for failing to settle billions of pesos worth of claims from private hospitals, some of which even threatened to cut ties with the agency.

According to PHAPi, PhilHealth continues to settle the claims of private hospitals, which had ballooned to ₱25 billion. It added that the health insurer vowed to complete the reimbursements in July.

“So far, ‘yung ₱25 billion, supposedly, na hinihingi namin na reimbursement, unti-unti, binibigay ito ng PhilHealth. May mga areas na nagsasabi na umabot na ng around 70% to 80% nung kanilang kine-claim. But then meron din pong areas, like areas in Isabela, na nagsasabi na napakarami pa rin pong hindi naibibigay sa kanila at ito ay noong panahon pa ng COVID in 2020 at tsaka 2021,” De Grano said.

[Translation: So far, the supposed ₱25 billion we are asking for as reimbursement are being given out gradually by PhilHealth. There are areas that say they already received around 70% to 80% of their claims. But there are also areas, like in Isabela, that say they still haven’t received a lot of money due them, and this was during the onset of COVID-19 pandemic in 2020 and 2021.]

The PHAPi president added that they agreed to continue the accreditation and negotiation with PhilHealth.

Kapag hindi kami nagpa-accredit (sa PhilHealth), ang kawawa po ‘yung ating mga beneficiaries. So kinonsider po namin ‘yan bago mag-decide whether to accredit ulit,” De Grado said.

[Translation: If we don't accredit with PhilHealth, the beneficiaries will suffer. So, we considered that before we decided to accredit again.]