CAMARINES Sur Rep. Luis Raymund Villafuerte yesterday said some doctors, especially those who expect to receive between P100,000 to P200,000 or more in professional fees (PFs) for their services, refuse to accept guarantee letters granted to indigent patients under the Department of Health’s (DOH) Medical Assistance for Indigent Patients (MAIP) program.
Villafuerte said the refusal has caused delays in the discharge of patients, subsequently further raising the patients’ hospital bills.
The lawmaker, who is the president of the National Unity Party (NUP), said some physicians do not honor the GLs because the MAIP only pays for a maximum of 50 percent of their professional fees and it takes them about two months or more to encash it.
“The issue really is they don’t honor the provision in the Memorandum of Agreement (MOA), which they signed, that at least 50 percent of their PFs can be covered by the MAIP,” Villafuerte said.
The DOH has inked MOAs on the MAIP with over 1,300 private health care institutions (HCIs).
Villafuerte said the non-acceptance by certain physicians of GLs has been a common complaint from patients in national and LGU hospitals, like the Bicol Medical Center.
He said affected patients cannot leave the hospitals even when they are already well because they lack the requisite clearances from their attending physicians for them to be discharged.
The DOH’s MAIP, a medical subsidy program for poor patients suffering from “catastrophic” or prolonged severe illnesses requiring costly treatment, has a P22 billion budget under the 2024 proposed national budget.
Villafuerte said he has already raised the issues with Health Secretary Teodoro Herbosa, who told him that he was aware of this dilemma while vowing to resolve it by issuing an order prohibiting private doctors accredited by the DOH to treat patients confined in government hospitals from rejecting MAIP-issued GLs.
The Bicolano congressman said Herbosa has assured him that the DOH can take action against the private doctors by withdrawing their DOH accreditation which allows them to practice in national and local government unit (LGU) hospitals.
He said Herbosa has also told him that the DOH is planning to reform and computerize the MAIP system to make it faster for physicians to convert their GLs into cash and make it easier for patient-beneficiaries to process the documentary requirements of their claims online or via a designated website.
Villafuerte said Herbosa is also looking into seeking an adjustment in the current administrative cost equivalent to two percent of the annual MAIP Fund to a higher five percent so the DOH can, for one, hire more staff to handle the processing of documents, which gets more complex and tedious as the annual MAIP budget and number of beneficiaries get bigger each year.
Following the enactment of Republic Act (RA) 11463 or the “Malasakit Centers Act” in 2019, the DOH issued Administrative Order (AO) 2020-0060 that revised the guidelines on the implementation of the MAIP by improving the reach and coverage of medical aid given to indigent patients and harmonizing with the MAIP all other funding sources for medical assistance.
One of the lead authors of RA 11463, Villafuerte said this law provided for the establishment of Malasakit Centers in all DOH hospitals as one-stop shops for the provision of medical and financial assistance — in the form of GLs, promissory notes or vouchers — to indigent or financially incapacitated Filipinos for their out-of-pocket expenses for medical and surgical services plus professional fees (PFs) that are not covered by their PhilHealth benefits or other insurance coverage.
For cases where the needed procedures, services and drugs are not available in government hospitals, or when there are no available beds in these health facilities, the heads of the concerned institutions may enter into MOAs with partner private hospitals or HCIs for the patients to be confined, with the subsequent expenses shouldered by MAIP.
Apart from the delayed payment and the discounted PFs, Villafuerte said some doctors refuse to accept GLs because they most probably do not want to declare such earnings for purposes of tax-payment.
Villafuerte said doctors need to declare the government-issued GLs as income and pay taxes even if there is no assurance yet as to when they will actually get paid.
The lawmaker said Herbosa has acknowledged the concern, saying he, himself, has heard that some doctors want to be paid in cash because they do not want to pay taxes before receiving their PFs since it takes time to encash the GLs.