AS more and more coronavirus disease (COVID-19) cases flock to hospitals, the Philippine Health Insurance Corporation (PhilHealth) yesterday assured all patients staying in emergency rooms (ERs) and makeshift tents that their expenses shall be covered.
In a statement, the agency said PhilHealth Circular No. 35-2013 ensures that those staying within hospital premises pending availability of rooms are entitled to full benefits.
“Patients admitted in ERs and tents within the hospital compound pending availability of hospital rooms are covered,” said PhilHealth.
The state-run health insurer said this means that patients, including COVID-19 cases, being admitted and managed in ERs due to lack of available regular rooms shall be paid by PhilHealth if the patient stayed within the hospital for at least 24 hours.
Similarly, PhilHealth said beneficiaries who are admitted in tents within the compound of accredited hospitals in areas categorized as high to critical risk for COVID-19, will be compensated starting last March 29, 2021.
In addition, PhilHealth appealed to healthcare professionals to extend coverage of benefits to patients facing full capacity hospitals.
“PhilHealth calls on health care providers to honor all availments including those of patients staying in tents, ERs, or within the hospital premises, wherein services are provided as part of the inpatient care,” it said.
PhilHealth’s statement comes as several hospitals are already declaring full capacity for COVID-19 patients. This has forced several hospitals to put up makeshift tents within the hospital compound in a bid to accommodate patients.
There have also been reports of COVID-19 patients being forced to stay inside their vehicles parked outside hospitals while waiting for available rooms.
Also yesterday, lawmakers were able to persuade PhilHealth president Dante Gierran to move for the reconsideration of a retroactive clause under PhilHealth Circular No. 2021-008, which provides that the coverage of COVID-19 inpatient packages are for confirmed cases only.
Gierran vowed to raise the issue before the PhilHealth board after congressmen complained that the retroactive clause, which was released only last June, covered hospital admissions from November 26, 2020.
Under the clause, probable COVID cases can only avail of an intermediate package, a policy perceived to be unfair for hospitals that granted PhilHealth coverage to suspected COVID-19 patients from November 2020 to June 2021.
The circular stopped COVID-19 probable cases from availing of in-patient package because it is allegedly being abused by some who have not acquired the virus.
“I would certainly would recommend to the board being the highest authority in the corporation to have this matter be taken into consideration for favorable action,” Gierran told a separate hearing of the committee on health.
Among those who questioned the circular were Quezon Rep. Helen Tan, panel chair, and Nueva Ecija Rep. Estrellita Suansing who presided over the hearing.
Gierran irked lawmakers when he earlier urged healthcare institutions to just contest their denied claims by filing arbitration cases.
President Duterte on Monday night directed Health Secretary Francisco Duque III to prioritize the release of benefits due to the country’s health workers if there is enough government money.
Duterte, during the Talk to the People address, also told Duque to borrow money if needed to buy more medicines.
“Prioritize the frontliners.If there is enough money, pay them,” he said.
The Alliance of Health Workers has earlier threatened to launch a mass protest over the government’s failure to heed their appeals for more benefits and warned that health professionals are already overworked.
Some health workers groups from both public and private hospitals have been saying that they have yet to receive their allowances and complained about the removal of some benefits such as meal, transportation and accommodation allowances.
Under the law, health workers are covered by hazard pay and special risk allowance.
The President, meanwhile, said he wants 30 hospitals, similar to the Southern Philippines Medical Center (SPMC) in Davao City to be put up around Mindanao.
Duterte likened the SPMC, which was previously known as the Davao Medical Center, to a private hospital in terms of facilities and delivery of medical services.
He told Department of Health Undersecretary and treatment czar Leopolodo Vega, who used to be affiliated with the SPMC, to put up at least 30 hospitals in Mindanao similar to the SPMC or the regional government hospitals to accommodate and serve more people. — With Wendell Vigilia and Jocelyn Montemayor
