MANILA — PhilHealth's reimbursement of coronavirus tests is rife with "syndicated corruption," a lawmaker claimed Thursday, adding to the allegations of wrongdoing by officials of the state medical insurer tasked to help Filipinos weather the pandemic.
House Deputy Majority Leader Bernadette Herrera said she received complaints that some PhilHealth members were asked by hospitals and laboratories to give their identification numbers needed for the reimbursement of COVID-19 tests that they paid out of their own pocket.
She said her brother, Quezon City Councillor Bernard Herrera, almost fell victim to the scheme. He was asked to give his PhilHealth number by a Pampanga hospital that processed his coronavirus test, which he paid for, said the lawmaker.
The hospital no longer replied when he pressed them to give more details, said Herrera.
"With all the accredited hospitals, how will PhilHealth know if a member paid for their own swab test? Once they (hospitals and labs) know the PhilHealth member, they can just reimburse again anything under the sun," she told ANC.
"PhilHealth is blind as to who is reimbursing what," added the representative of Bagong Henerasyon party-list.
PhilHealth has a budget of about P30 billion for 10.12 million COVID-19 tests. However, the insurer has paid for only 12,571 tests as of Sept. 4, said the congresswoman.
Herrera blamed this on PhilHealth's alleged failure to inform the public about who could get free tests.
"Maraming pwede mag-claim ng libreng PCR testing, hindi na-publicize at maraming qualified ay hindi alam, may 105 kayong accredited hospitals and testing centers, pero hindi nagagamit ang budgeted amounts. Bakit kaya?" she said in a statement.
(Many can claim free PCR testing, but many of those qualified do not know this because it was not publicized. You have 105 accredited hospitals and testing centers, but the budgeted amounts are not being used. Why?)
“The answer, is the syndicated corruption that is plaguing the country, from both private hospitals and centers, empowered by the good-for-nothings within PhilHealth.”
PhilHealth will ask for a full report from Herrera so it can respond to her allegation, it said in a statement published by Business Mirror.
"If the facilities indeed took advantage of the patient, this is clearly a violation of their performance commitment that they are bound to adhere to, and will have consequences under existing rules," said PhilHealth.
The DOH had earlier listed at-risk individuals who must be given priority for free PCR testing, including the following, said Herrera.
- Patients with severe symptoms and those with mild symptoms who have travel history in COVID-19 hotspots or contact with patients
- Health care workers
- Senior citizens
- Returning overseas Filipino workers
- Workers in the tourist zones, local manufacturing companies, transport and logistics, food retail, education, financial services, non-food retail, services, public market, construction; water supply, sewerage, and waste management; public sector, and mass media.
"Members falling under these sub-groups are entitled to full coverage without co-payment in all accredited testing facilities nationwide," said PhilHealth.
"They should not be asked to pay for any fees that are already covered by the Philhealth package. Qualified members who paid for their tests can file their claims directly with PhilHealth."