We had a private meeting with PhilHealth and PHAPI. They reached an understanding.

Senator Christopher Lawrence “Bong” Go assists an elderly resident of San Pedro, Laguna who is among victims of a recent fire as he pursues his aim to be a catalyst of a better life for ordinary Filipinos.

Private hospitals and the state health insurer have settled their differences over billions of pesos of unpaid claims that, in effect, would realize in full the free medical services provided under the Universal Health Care (UHC) law, the implementation of which starts next year.

Sen. Christopher Lawrence “Bong” Go said the Philippine Health Insurance Corp. (PhilHealth) and the Private Hospitals Association of the Philippines Inc. (PHAPI) have agreed in a private meeting on Thursday to settle the issue to prevent the disruption in the landmark law’s start.

“On Thursday, we had a private meeting with PhilHealth and PHAPI. They reached an understanding, at first there was a heated exchange but later on they came to agree from both sides,” Go said in a radio interview.

“They agreed to work closely to resolve the alleged fraudulent claims and PhilHealth said it was ready to listen to private hospitals’ representatives,” he added.

PhilHealth is preparing for the gradual implementation of the UHC law that begins on 1 January 2020. PhilHealth President and Chief Executive Officer Ricardo Morales said necessary preparations have been started for the UHC rollout.

He said included in the preparations are the identification of the initial areas and demographics to be covered by the program, budget appropriation, identification of clinics, hospitals and other facilities that would provide the service and a communications plan.

A hump on the smooth implementation of the law happened last week as a result of some disgruntled private hospitals who indicated plans to cut ties with the government.

Morales said members of PHAPI officials who he talked to denied the threat of separating from the agency.

“There is no truth to the threat that there will be 600 hospitals which will pull out. All the hospitals we have talked to denied this,” Morales said.

In a separate radio interview, PHAPI president Dr. Rustico Jimenez confirmed Go’s statement and said an agreement has been sealed.

Some 600 PHAPI members considered not renewing their PhilHealth accreditation in 2020 due to P2.5 billion in reimbursements that had accumulated.

The Senator said PhilHealth will call for quarterly regional forums for hospitals to tackle concerns on such claims and said private hospitals did not threaten to pull out from PhilHealth.

Hopefully, the relations will further improve for the sake of the poor patients.”

Go, who is chairman of the Senate Committee on Health and Demography, said PhilHealth is committed to paying the claims.

“Involved here are people’s money so my sole intention is to protect public funds so that nothing is wasted,” the senator indicated.

Go said hospitals found committing violations will have their accreditation revoked but he indicated, thus far, PHAPI and PhilHealth have agreed to have an “open line.”

PHAPI also appealed to the agency not to strip member-private hospitals of their accreditation.

Jimenez said if private hospitals under the PhilHealth program fail to collect their due from the state insurer and would eventually be unable to shoulder unpaid accounts, they would be forced to either shut down or cut their membership in the state health system.

The PHAPI president pointed out that if the situation remains unaddressed, poor patients would ultimately suffer the most.

“If they remove the accreditation, then those who will suffer most are the patients,” said Jimenez.

Earlier, PhilHealth said that caution against fraud caused delays in the payment of its hospital obligations. Morales explained that the delays were due to the strict process of ensuring that only authentic claims would be paid for.

Morales cited a recent controversy over “ghost dialysis” in which its partner WellMed Dialysis & Laboratory Center Corporation supposedly processed and benefited from claims of deceased or “ghost” patients.