Lacson: Advance deposits for lying-in and dialysis ‘illegal’, citing PhilHealth’s circular

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Sen. Panfilo Lacson zeroes in on Health Secretary Francisco Duque’s claim that dialysis centers and maternity clinics were eligible to receive funds from the Philippine Health Insurance Corp’s (PhilHealth) advance deposits for emergency events.

Duque claimed that the inclusion of dialysis centers and maternity wards in PhilHealth’s interim reimbursement mechanism (IRM) was normal, since these facilities were also affected by the COVID-19 pandemic.

“We are in a war against an invisible enemy and COVID patients are not the only casualties in this war,” Duque said. “IRM funds are not exclusive to hospitals catering to COVID-19 patients… because this PhilHealth mechanism ensures the provision of benefits for Filipinos,.”

Lacson then asked Duque to cite a specific provision in the IRM circular published by PhilHealth that supports his statement.

“Maski hanapin niyo maghapon, walang kayong makikita na magju-justify na puwede sakupin ng IRM ang non-COVID cases. Maski isang linggo kayo maghanap, wala kayo makikita,” Lacson said after Duque asked for time to review the documents.

[Even if you look for it all day, you won’t find anything that would justify that the IRM covers non-COVID cases. Even if you spend a week looking for it, you will not find it.]

The circular that authorizes the advance payment to hospitals only covers “fortuitous” or unforeseeen events, Lacson told Duque, citing several portions of the document.

“Ang dialysis po ba, fortuitous event? Hindi. ‘Yung maternity care fortuitous event po ba ‘yun? Hindi,” the senator said.

[Is dialysis a fortuitous event? No. Is maternity care a fortuitous event? No.]

Lacson reminded Duque – who has been in the PhilHealth’s board since 2001 – that the IRM is only used during natural or man-made calamities like Typhoon Ondoy in 2009, Supertyphoon Yolanda in 2013, the Marawi siege in 2017, and the Taal Volcano eruption in 2020.

While dialysis centers also receive reimbursements from PhilHealth, these are considered as “regular benefit claims,” Lacson said.

“‘Yang sinasabi ninyo, hindi tatama sa fortuitous event na COVID-19,” he said.

[What you are saying is not part of the fortuitous event called COVID-19.]

Duque agreed with Lacson and said that his office would “rectify” the wrong implementation of the IRM.

Senators have been criticizing PhilHealth officials for disbursing billions of funds to dialysis centers and maternity clinics during the pandemic, while hospitals deluged with COVID-19 patients have yet to be reimbursed.