THE Private Hospitals Association of the Philippines Inc. (PHAPi) yesterday asked the Philippine Health Insurance Corporation (PhilHealth) to consider increasing coverage for its hemodialysis benefit package to at least P5,500 per treatment session from the current P4,000.
“They increased the package by P1,400 from the original P2,600 to cover for the hemodialysis treatments… the additional is not enough to cover for the expenses,” Dr. Jose Rene de Grano, PHAPi president, said in an interview.
If an increase is not possible, the state-run health insurer must allow out-of-pocket expenses for PhilHealth members, he said.
“For private hospitals and free-standing dialysis centers, there should be out-of-pocket expenses for the patients and not no balance billing,” he said.
De Grano said his group is seeking an increase because many private hospitals and hemodialysis centers are experiencing losses, some at P300 to P1,000 per treatment session.
“Unless they do something about it, I think a lot of the dialysis centers will slowly close down,” he said.
“It may take a while but slowly most of them may elect to close rather than suffer too much losses,” added de Grano.
In 2023, PhilHealth approved the expansion of its coverage of hemodialysis treatment to 156 from 90 sessions a year. Last June, PhilHealth hiked the benefit package rate for hemodialysis to P4,000 from P2,600 per treatment session.
According to PhilHealth, covered by the hemodialysis benefit package are any of the following preparations of Erythropoietin listed in the latest edition of the Philippine National Formulary, particularly 4,000 units/vial, 5,000 units/vial, and 10,000 units/vial; iron sucrose IV, as indicated; and heparin or enoxaparin, as needed.
Also covered are any or all laboratory tests, as needed, such as complete blood count (CBC), serum creatinine, hepatitis profile, alkaline phosphatase, potassium /phosphorus /calcium, serum iron/ ferritin/transferrin, total iron binding capacity (TIBC), and albumin.
PhilHealth’s benefit package also covers either of the low-flux or high-flux types of dialyzers, as well as the use of HD machines, utilities, and staff time.
