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Sen. Imee Marcos sees legal in PhilHealth’s ‘Pera sa Pneumonia’

Senator Imelda “Imee” Marcos on Sunday urged the government to withhold some P10-billion funds of the Philippine Health Insurance Corp. (PhilHealth) that are not directed for the testing and treatment of COVID-19.

Marcos said PhilHealth may be taking advantage of a legal loophole under Republic Act No. 11332 or the law requiring that “notifiable” diseases be reported to the government and is evading a comprehensive audit of its fund releases.

Senator Imee R. Marcos
(Senate of the Philippines / FILE PHOTO / MANILA BULLETIN)

Under the law, Marcos noted pneumonia is excluded from the definition of a notifiable disease, and this is “allowing the band of vultures in PhilHealth to ignore a detailed accounting of pneumonia cases that are being used by hospitals to claim reimbursements through a bill-and-bribe scheme.”

“The legal loophole and the failure of Philhealth to submit a detailed breakdown on hospital claims abet the ‘Pera sa Pneumonia’ scam that involves overstated or false claims, like the upcasing of a common cold to pneumonia and the treatment of ghost patients,” Marcos said in a statement.

She said pneumonia has consistently been among the top diseases for which Philhealth has been releasing funds since the past administration until the present surge of the COVID-19 pandemic. But PhilHealth has failed to submit a breakdown on hospital claims despite the Senate’s request for the data last year.

Marcos said it is crucial that the Commission on Audit (COA) review the “Pera sa Pneumonia” program and be provided all the crucial information pertaining to it.

The senator has also filed Senate Bill No. 1416 to amend the said law so that pneumonia can be specifically identified as a “notifiable” disease and reportorial requirements are strengthened during pandemics and public health emergencies.

Earlier, Marcos recommended the suspension of the collection of PhilHealth premiums as allegations of corruption surfaced anew, particularly in the implementation of the Interim Reimbursement Mechanism (IRM) and the alleged overprice information technology (IT) system of the agency.

She said suspension of the collection of PhilHealth premiums is among the options government can take to plug the agency’s loss of billions in membership contributions and government subsidies to “the band of vultures in PhilHealth.”

She also said the government should consider creating an account where existing funds can be parked for safekeeping.

The government can also temporarily transfer procurement of PhilHealth supplies to the Department of Budget and Management (DBM), while authorities sort out the financial mess that’s plaguing the PhilHealth for decades, Marcos said.


Source: Manila Bulletin (https://mb.com.ph/2020/08/16/sen-imee-marcos-sees-legal-in-philhealths-pera-sa-pneumonia/?utm_source=rss&utm_medium=rss&utm_campaign=sen-imee-marcos-sees-legal-in-philhealths-pera-sa-pneumonia)

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