PhilHealth eyes libel over claim late payments forcing 300 hospitals to close

Private Hospitals Association of the Philippines chief Rustico Jimenez is practically blackmailing PhilHealth into ‘paying out public funds without due diligence,’ says the government-owned corporation

JC Gotinga

Published: 8:01 PM May 30, 2020

Updated: 8:04 PM May 30, 2020

MANILA, Philippines – The Philippine Health Insurance Corporation (PhilHealth) said it was exploring filing libel charges against Rustico Jimenez, president of the Private Hospitals Association of the Philippines (PHAP), over his claim that some 300 private hospitals face closure because of delayed reimbursements from the government-owned corporation.

“PhilHealth categorically denies as unfounded, malicious, and irresponsible” the statement Jimenez made in a televised interview on Wednesday, May 27, the government corporation said in a statement on Saturday, May 30.

Disbursements from January 1 to May 29 this year have amounted to P52.53 billion in claims payment and for its Interim Reimbursement Mechanism (IRM), PhilHealth said.

Of that amount, P21.8 billion were paid to private facilities, the corporation added.

Jimenez said more than half of PHAP’s 744 members have yet to receive IRM payments, and PhilHealth gave them a “runaround” when they inquired about it.

Because of this, half of the private hospitals in the group are so financially drained, they may face closure, Jimenez added.

PhilHealth said it never issued a “promise” to release IRM payments to all hospitals. “This was a misrepresentation of Dr Jimenez,” PhilHealth added.

“PhilHealth has earlier published a statement explaining the purpose and reconfiguration of the IRM program in order to husband its funds for the long term while concentrating on areas with high COVID-19 incidence,” it said.

PhilHealth president and CEO Ricardo Morales and Jimenez agreed in a meeting in Malacañang in 2019 to resolve payment issues by letting each hospital deal directly with their counterparts at PhilHealth to reconcile their books of accounts, PhilHealth said.

Hospitals that failed to meet “data quality standards” had their claims denied or delayed.

PhilHealth said it does not recognize Jimenez as a legitimate representative of any hospital association “because of his historical pattern of wild and unfounded accusations.”

“PhilHealth will not be threatened by what amounts to blackmail into paying out public funds without due diligence,” it said.

On Monday, May 25, PHAP also called on President Rodrigo Duterte to replace Health Secretary Francisco Duque III, who is also PhilHealth chairman, because of delayed reimbursements of health insurance claims. –