Tuesday, August 11, 2020

Davao hospital got biggest PhilHealth cash advance. Inquirer Newsletter. August 12, 2020

MARKET WATCH Looking for violators of health and safety regulations, an Army soldier extends his patrol to the interior of the public market in Taytay, Rizal province, on Tuesday. The municipality recently passed an ordinance requiring residents to wear not only protective masks but also face shields in public places to curb the transmission of the coronavirus. –GRIG C. MONTEGRANDE

World

Russia OKs vaccine but concerns raised

MOSCOW—Russian President Vladimir Putin said his country’s regulators had approved the locally developed vaccine for COVID-19. The approval of the vaccine named “Sputnik V” was given even before the start of the large-scale Phase 3 trial that stirred concern among world regulators, who said the rush to develop a shot against the new coronavirus disease should not compromise safety. -REPORTS FROM REUTERS AND AFP

Regions

Foot traffic gone in ‘tsinelas’ capital

Business has not been good these days for footwear stores in Liliw, the “tsinelas” capital of Laguna province, as the pandemic kept tourists out. Bulk orders for locally made sandals and slippers had also been canceled due to the closure of shopping malls and department stores. Liliw hosts 200 footwear manufacturers and retailers, each employing 10 to 50 people in the industry that started in the 1930s. —STORY BY MARICAR CINCO

Sports

Lifesaver Casugay scoops up a 1st for PH

Philippine surfing ace Roger Casugay, for rescuing Indonesian foe Arip Nurhidayat from drowning in the Southeast Asian Games’ longboard semifinals last year, will receive the prestigious Pierre de Coubertin Act of Fair Play Award from the Comite International du Fair-Play (International Fair Play Committee)—a first for a Filipino. The health situation permitting, the awards ceremony is set on Oct. 20 in Monaco. -STORY BY JUNE NAVARRO

Newsletter / Join us

Has this been forwarded by a friend? Subscribe now to the Philippine Daily Inquirer Newsletter and get your latest news and important updates on COVID-19 and the enhanced community quarantine.

Banner story

Davao hospital got biggest PhilHealth cash advance

By Marlon Ramos

Weeks before it approved the guidelines for the use of special funds for the government’s COVID-19 response, Philippine Health Insurance Corp. (PhilHealth) had already handed out P9.3 billion in cash advances to various hospitals, especially favored health facilities, Sen. Panfilo Lacson disclosed on Tuesday.

At the resumption of the Senate hearing on the corruption scandal hounding the state-run health insurer, PhilHealth officials said a hospital in Davao City was the biggest recipient of funds from the P30-billion Interim Reimbursement Mechanism (IRM).

Southern Philippines Medical Center, a public hospital in President Duterte’s hometown, received P326 million.

The University of the Philippines-Philippine General Hospital in Manila, a major referral hospital for COVID-19 patients, received P262.3 million in advance payment.
Another hospital in Davao region, Davao Regional Medical Center in Tagum City, ranked third, getting P209 million.

Lacson, Senate President Vicente Sotto III and other senators pounced on the questionable distribution of the IRM allocations, which were specifically allocated for hospitals treating patients infected with the new coronavirus.

Lacson said a review of PhilHealth records showed a “pattern” that some hospitals, particularly private-owned, were favored in the distribution of IRM over state-owned hospitals.

For example, he said Eastern Samar Gov. Ben Evardone had been complaining about the delay in the reimbursement of P24 million in benefit claims of at least 10 district hospitals in the province.

“There’s a pattern here. Why is this happening? There seems to be favoritism in choosing… private hospitals receiving IRM funds,” Lacson said.

Sen. Joel Villanueva said the swift release of P45 million in cash advances to B. Braun Avitum Philippines despite the dialysis center’s pending cases in PhilHealth proved that the health insurer had given preferential treatment to certain health facilities.

“I don’t think there’s any doubt that there’s favoritism in PhilHealth,” Villanueva said.

Lacson said records showed that B. Braun was not even registered with the Securities and Exchange Commission.

“Are you not conducting due diligence? You are releasing millions of pesos,” Lacson said. “You made advance payments to B. Braun, which is charging their patients for dialysis. So where did the money that you gave go?”

Thorrsson Montes Keith, who had resigned as PhilHealth antifraud legal officer, said he suspected PhilHealth Senior Vice President Rodolfo del Rosario actually owned B. Braun, based on the deposits made to a rural bank in Balanga, Bataan province, which the PhilHealth official allegedly frequented.

Del Rosario denied owning the dialysis center.

LP bailiwick
Senate Minority Leader Franklin Drilon also lamented that the requests for IRM funds of 33 hospitals in his home region of Western Visayas, regarded as the bailiwick of the opposition Liberal Party, had not been granted by PhilHealth since April 6.

“Up to this point, not a single peso was released to these 33 hospitals,” Drilon said.

But Robert Labe Jr., PhilHealth corporate counsel, insisted that all the IRM releases were consistent with PhilHealth’s existing regulations. “The IRM is not provided arbitrarily. There is a process being followed,” he said.

Sotto, who spearheaded the investigation along with Lacson, asked PhilHealth President and CEO Ricardo Morales about the legal basis of the IRM that would justify the distribution of billions of pesos in cash advances to public and private health facilities.

Morales, who joined the hearing via the internet, said Republic Act No. 7875, the law that created PhilHealth, allowed it to “supervise the provision of health benefits… and set standards, rules and regulations necessary to ensure quality” of health care in the country.

But Sotto said the concept of “payment mechanism” as stated in the law was different from “financial mechanism” that the PhilHealth board cited in creating IRM.

“Does PhilHealth have the power to finance any (hospital)? That’s not included in your mandate, right?” Sotto asked the PhilHealth chief. Morales agreed, adding that the corporation’s authority was to pay for health services.

Anticipating COVID-19
Morales claimed that the PhilHealth board had started discussions on crafting IRM as early as January in anticipation of the effects of COVID-19.

“We were in the state of anxiety (then) because we knew COVID-19 was coming,” Morales said. “We wanted to take preemptive measures to be able to prepare our hospitals to respond to this pandemic.”

Lacson and Drilon took Morales to task for claiming that PhilHealth came up with the idea about the IRM in January. Drilon pointed out that Health Secretary Francisco Duque III was telling the public in early March that there was no need for the public to worry.

PhilHealth board member Alejandro Cabading and Dr. Susan Mercado, who recently resigned from the board, denied Morales’ statement.

“As far as I can recall, we were not talking about COVID-19 (that time),” Mercado said, adding that it was not the board that initially allotted P27 billion for IRM.

Replying to Lacson’s queries, Mercado said the PhilHealth board was just “informed and asked to endorse” PhilHealth Circular No. 2020-0007, which Morales supposedly signed on March 20.

Antedated resolution
At the time, Lacson said, official PhilHealth records showed that the company had already released P703 million.

Showing another set of documents, the senator said the resolution was “antedated,” as it was finalized only on April 22, or more than a month after the health insurer started disbursing IRM funds.

Lacson said PhilHealth’s IRM distribution had already ballooned to P9.3 billion by then. Worse, PhilHealth adopted only on March 31 Board Resolution No. 2515, which was needed to justify the March 20 circular, according to the senator.

“So what were the guidelines (used by) the regional vice presidents in issuing IRM when the guidelines, called the SOP (standard operating procedures), were issued only after (the funds had been distributed)?” Lacson asked.

‘Some expedients’
In response, Morales explained: “In the administration of our efforts, there were some expedients that had to be adopted because we did not know the possible impact of COVID-19.”

“We had to immediately release the funds. But we made sure that all the releases were covered by a contract and that we would be able to account for all the funds that were (made) available,” he added.

Lacson wondered why the cart came before the horse. “The (board) resolution is the one which should pull the cart,” he told Morales.

P1,000 for fake patients
Senate Majority Leader Juan Miguel Zubiri said PhilHealth investigators had informed him that many unscrupulous hospitals were not only involved in “upcasing” of treatments, but were also behind the “nonexistent patients” and rebates schemes.

Zubiri said these hospitals were allegedly paying individuals P1,000 each for “acting” as patients, who were entitled to reimbursements from the health insurer. “Some (hospitals) pay people P1,000 to act as patients in order to (collect benefit) claims for more serious ailments from PhilHealth,” he said.

Editorial

Big talk, big mistake

Too bad the new Armed Forces chief of staff began his brief—six months—term of office with what Sen. Panfilo Lacson later described as an "ill-advised" statement. At his first press briefing as military chief, Lt. Gen. Gilbert Gapay said provisions on the regulation of the use of social media should be included in the implementing rules and regulations (IRRs) of the Anti-Terrorism Act. It expectedly drew heavy flak, so that days later the multiawarded and -decorated officer was compelled to say: "What I meant by that is to regulate and put order on the social media platforms, not the users per se."

Surely Gapay sees the wisdom of working with, and not against, the people before retiring from fruitful military service in February 2021. Perhaps he can deepen his awareness of realities by studying the petitions filed in the Supreme Court—27 at this writing—against the Anti-Terrorism Act by, among others, a "lumad" school, rights advocates, congressmen from Mindanao, journalists, and such lawyers as former senator Rene Saguisag and former mayor Jojo Binay. One petition, filed by former Supreme Court associate justices Antonio Carpio and Conchita Carpio Morales and UP College of Law faculty and students, delivers the message simply: The antiterrorism law 'chills free speech, brazenly violates the principle of the separation of powers, and grants the executive branch powers beyond what the Constitution permits.'

Read full story: opinion.inquirer.net