Hontiveros eyes bill protecting Philhealth from false claims

Robie de Guzman   •   August 1, 2019   •   1129

Senator Risa Hontiveros

MANILA, Philippines – Opposition Senator Risa Hontiveros on Wednesday said she is planning to file a bill seeking to protect the Philippine Health Insurance Corp. (Philhealth) from fraudulent activities such as overpayments and false claims.

Hontiveros said the bill, which will be called the PhilHealth Insurance False Claims Act, is seen to deter and minimize fraud notwithstanding the penalties provided for under the Universal Health Care (UHC) Act.

The senator said she will file the bill after Senator Panfilo Lacson revealed that the Philhealth incurred billions of losses due to alleged fraudulent benefit claims involving corrupt health officials.

“The seriousness and disturbing nature of these allegations should prompt a review of PhilHealth’s anti-fraud mechanisms,” she said in a statement.

“Every peso lost to corruption in our health programs would mean that a citizen is deprived of potentially life-saving medication or treatment. Corruption makes our people unhealthy and even threatens their lives,” she added.

Under the bill, Hontiveros proposes to improve PhilHealth’s fraud detection mechanisms, including a shift from the current case rate payment to a diagnosis-related grouping provider payment mechanism, and providing support to PhilHealth staff who flag anomalies.

She also wants to revisit the penalty of suspending hospital operations and seriously consider imposing monetary penalties that are at least three times the amount of detected fraud.

Hontiveros said she was particularly alarmed over the report that PhilHealth continues to overpay fraudulent hospitals and clinics via “overstaying” or “ghost” patients.

“Mukhang tuloy-tuloy ang mga anomalya mula sa hakot operation ng mga eye clinics, ghost dialysis patients hanggang sa mga kontrobersyal na repayments. Hindi maaari ito,” she said.

“Defrauding the government and depriving countless Filipinos of access to health services is an unacceptable and criminal misuse of public money. Every single peso under our health programs could potentially spell the difference between life and death for our constituents. Let us make sure that it is well spent and will not end up in the pockets of the corrupt,” she added.

NBI urged to take down online pages promoting sexual exploitation of children

Robie de Guzman   •   May 15, 2020

MANILA, Philippines – Senator Risa Hontiveros has called on the National Bureau of Investigation (NBI) to put a stop to social media pages that sexually exploit children following reports of continuing exploitation of children even amid the novel coronavirus disease (COVID-19) pandemic.

In an open letter addressed to the NBI, Hontiveros said her office received reports that there are still pages on Facebook and other online sites that are actively posting indecent photos of female children.

“Nakarating sa opisina ko na mayroong mga Facebook pages kung saan naka-post ang napakaraming mahahalay na larawan ng mga babaeng bata. Matagal na ang mga Facebook page na ito ngunit active pa rin daw ang mga posts at groups,” she said.

“Ngayong COVID-19 pandemic, may mga reports na nagsasabing pwedeng mas dadami ang kaso ng online sexual exploitation of children. We need to be more vigilant and make sure that our children are safe and secure, online and offline,” she stressed.

Hontiveros appealed to the bureau to probe and takedown these pages, as well as find and prosecute the people behind these social media accounts.

“Nananawagan ako sa Bureau na imbestigahan at agarang i-take down ang mga Facebook pages na ito. Kailangan malaman din ng NBI kung sino-sino ang mga taong nagpapatakbo nito. Kailangang panagutin at ipakulong ang mga kriminal na nasa likod ng mga Facebook pages at online content na ito,” she stressed.

According to the senator, Facebook also needs to be made accountable for allowing these pages.

“The tech giant, with all its resources, should have technologies and mechanisms in place that prevent these kinds of pages from existing. Sobrang nakakabahala na hanggang ngayon, may mga ganito paring nangyayari sa platform na ito,” she said.

She also called on the public to remain vigilant in ending online sexual exploitation of children by reporting these pages to authorities.

“Kailangan nating protektahan ang online space bilang mga safe spaces. We need to make sure that our children are safe online, lalo na ngayong mas marami ang oras na ginugugol nila sa social media,” she said.

Duterte orders PhilHealth to make premium payment for OFWs voluntary

Marje Pelayo   •   May 4, 2020

MANILA, Philippines — President Rodrigo Duterte has directed state insurer Philippine Health Insurance Corporation (PhilHealth) to make premium contributions voluntary for overseas Filipino workers (OFWs) due to mounting complaints from Filipinos here and abroad.

READ: PhilHealth’s 3% mandatory pay hike amid global pandemic draws public ire

The President wants to ensure that no further load will be added to OFWs at this time of health and financial crisis brought about by the coronavirus disease (COVID-19) pandemic. 

Nag-issue po ng direktiba ang ating Presidente sa Philhealth para gawing boluntaryo ang pagbabayad ng OFWs ng Philhealth premiums, [The President has already directed PhilHealth to make payment for PhilHealth contributionrs for OFWs voluntary,]” Roque confirmed. 

Roque, being one of the principal authors of the Universal Health Care Act during his time as Representative of Kabayan Partylist in the 17th Congress, stressed that there was no provision on his version of the law that orders mandatory additional premium contribution among OFWs.

He added that it was PhilHealth that included such provision as it is the one that crafted the implementing rules and regulations (IRR) of the said law.

Roque also clarified that PhilHealth premiums will only increase by 0.5%, and not 3%.

“Wala po sa batas na nagsasabi na dapat patawan ang mga OFWs ng karagdagang premiums sa pamamaraan na nais ipatupad ng Philhealth, [Mandatory payment of premium contributions for OFWs was not included in the original version the way PhilHealth wants it to happen,]” Roque.

“Iyan po ay nasa implementing rules and regulations, [They included it in the implementing rules and regulations,]” he added.

Roque also clarified that the Overseas Workers Welfare Administration (OWWA) and the Philippine Overseas Employment Administration (POEA) do not require payments of PhilHealth premiums prior to processing of Overseas Employment Certificate (OEC). MNP (with inputs from Rosalie Coz)

Philhealth: Collection of contribution suspended amid COVID-19 crisis

Robie de Guzman   •   May 4, 2020

MANILA, Philippines – The Philippine Health Insurance Corporation (Philhealth) on Monday clarified that all collections of contribution have been temporarily suspended amid the crisis brought about by the spread of novel coronavirus disease (COVID-19).

In an interview in UNTV’s Serbisyong Bayanihan Program, Philhealth spokesperson Dr. Shirley Domingo said the collection was suspended in consideration of those who are not receiving their monthly salaries due to the work stoppage in different sectors amid the COVID-19 pandemic.

The Philhealth issued the statement following protests of overseas Filipino workers (OFW) on the new premium rates imposed by the state health insurer.

READ: Mga OFW, may apela kaugnay ng dagdag-kontribusyon sa Philhealth

An online petition against the premium rate hike has so far reached over 300,000 signatures, as of posting time.

The protest stemmed from the Circular 2020-0014 issued by the agency in April requiring OFWs who are earning P10,000 to P60,000 to pay three percent of their monthly salary starting 2020. This is higher than the 2.75% in the previous year.

Domingo said the implementation of the increased rate is stated under the Republic Act 11223 or the Universal Health Care Act, stressing that they are only following the law.

However, she emphasized that in recognition of the present situation, Philhealth is not collecting any contribution at this time.

Domingo also said that the agency has adopted a flexible payment scheme where OFWs and other members can finish their premiums for the year.

In a separate statement, Philhealth president and CEO Ricardo Morales assured they fully understand the sentiments of OFWs regarding the increase in premiums, and that they are exploring several possibilities to cushion its impact.

“Recognizing that everyone is cash-strapped during these difficult times, and in the spirit of the recently passed Republic Act 11469 or the Bayanihan We Heal As One Law which is government’s response to the Covid-19 pandemic, PhilHealth has adopted a flexible payment scheme which will allow OFWs – and all other directly paying self-employed members – to pay their contributions within the year,” Morales said.

He said the Philhealth had earlier released P30 billion in advance to some 5,000 nationwide accredited hospitals to provide financial protection to Filipinos amid the COVID-19 crisis.

He also explained that the purpose of the Universal Health Care Act is to provide affordable and adequate healthcare to all Filipinos.

“Such a program requires funding collected through premium contributions,” Morales said.

He reported that in 2019, 44% of the premiums were subsidized by the national government while the balance was collected from individual members and their employers, where OFWs are counted.

“Benefits-wise, 36% of beneficiaries were from the informal and private sector while 37% were accounted for from the indigents and senior citizens whose premiums were paid by the national government,” he said.

“Last year, with a collection from OFWs amounting to P 1.02 Billion (comprising 1% of premiums from direct contributors), OFWs claimed P 1.7 Billion in benefits with 69% of claims attributed to their dependents in the country while 31% was claimed by overseas OFWs,” he added.

Under the UHC Act, benefit coverage is planned to be increased and expanded so that more Filipinos can be served better.

“This is the fundamental basis for the premium increase. These ambitious health goals must be supported by adequate funding collected through increased premium rates,” Morales said.

“PhilHealth commits to continue exploring means to soften and alleviate the impact of the premium rate increase, but it cannot change the law,” he added. – RRD (with details from Correspondent Aiko Miguel)

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