THE Philippine Health Insurance Corporation (PhilHealth) yesterday assured the public that its emergency cash advance program during the coronavirus disease (COVID-19) pandemic is legal and above board.
In a statement, PhilHealth president and CEO Ricardo Morales said the Interim Reimbursement Mechanism (IRM) is aimed at helping medical facilities admitting COVID-19 patients.
“All transactions on IRM are aboveboard and within the guidelines set by the corporation,” said Morales.
He rejected the claim of Thorrsson Montes Keith, who recently resigned as anti-fraud legal officer of the agency, that the IRM is exempted from liquidation requirements.
Keith has also said the IRM is being used for anomalous schemes by those involved in corrupt practices at PhilHealth.
“Liquidation is definitely a must,” Morales said. “But since we are in unusual times, we made the timing of liquidation flexible with such options left to the good judgement of the regions given the situations that hospitals are in.”
Morales belied claims that PhilHealth is favoring certain hospitals or it quickly released the IRM to some medical facilities.
“IRM releases are based on the historical claims of hospitals, and undergo a process of application, evaluation, validation and recommendation at the level of the PhilHealth regional offices, and approval at its head office,” he said.
Morales also said the IRM is available to all healthcare facilities, including lying-in centers and dialysis clinics as well as those with pending cases.
“The whole point here is to ensure that we are able to help in making sure that as many facilities are open and able to serve patients,” Morales said.
PhilHealth said it is evaluating a second wave of IRM, particularly for those considered as high COVID-19 concentration areas.
These include hospitals in the National Capital Region, Central Luzon, Calabarzon, Central Visayas, and Eastern Visayas as these are the areas, where bed capacity either reached full capacity or are in critical levels.
“This is to ensure that sufficient funds are available for all citizens needing health care,” said Morales.
Keith’s claims of corruption in the agency has prompted senators to call for an inquiry into the latest allegations of anomalies at the state-run insurer.
Sen. Panfilo Lacson over the weekend said the Senate inquiry will reveal more “malevolent” schemes at PhilHealth. He cited the RIM “led to the release of hundreds of millions of pesos in record time — in one or two weeks — to a few unaccredited hospitals that register only one COVID-19 patient.”
