Dialysis centers oppose no-balance billing system

Hundreds of private dialysis centers in the Philippines are on the verge of shutting down, jeopardizing the treatment of thousands of patients with chronic kidney disease, a dialysis industry group warned.

The Dialysis Coalition of the Philippines Inc. (DCPI) said it supports PhilHealth’s decision to increase the number of subsidized hemodialysis (HD) sessions to 156 per year.

However, the group expressed concerns about PhilHealth Circular 2024-0014 which sets the reimbursement rate for each session at P4,000 and prohibits additional charges to patients under the “No Balance Billing” system.

“The policy of no balance billing aptly applies to government health care institutions,” DCPI president Dr. Michael Manalaysay said in a letter to PhilHealth president and CEO Emmanuel Ledesma. “Private enterprises must not be regarded as government-owned institutions.”

The DCPI argued that the P4,000 rate doesn’t cover all the expenses associated with HD treatment, including essential medications and tests. They initially proposed a rate of P5,200.

Manalaysay said the new rate includes the cost of medications like Erythropoietin (EPO), Iron Sucrose, and Enoxaparin, which were previously shouldered by the patients or obtained through charity.

While this inclusion is a benefit, private centers say it strains their budgets further.

The DCPI proposed a compromise: accept the P4,000 rate as long as it excludes the cost of the aforementioned medications. This, they argued, would allow private centers to stay afloat and continue serving patients.