Pangasinan LGUs seek accounting of Philhealth YAKAP health funds

Three local government units of Bayambang, Urdaneta City and Malasiqui in Pangasinan province on Wednesday formally filed a joint petition with the Philippine Health Insurance Corp. (PhilHealth), seeking a certified, LGU-by-LGU accounting of primary-care funds being handled under Pangasinan’s province-wide health system

The three local governments, represented by their legal counsel and spokesperson Atty. Hue Jyro U. Go, submitted their petition at the PhilHealth head pffice in Pasig City to question where does the P1,700 in PhilHealth primary-care funding attributable to every qualified beneficiary in Pangasinan actually go.

"But because of this centralization that we're doing in the province-wide jurisdiction, what's happening is 80 percent is pooled in the provincial level and 20 percent is then downloaded to the local government unis. So that would result to roughly around P340 for the beneficiary themselves. So the question is, what happened to P1,360? That's what we're asking from PhilHealth," Go said in an ambush interview.

"We request for transparency. In fact, we've already reached out to the provincial level and asked, where will this money go? Usually, according to the law, it should go to facilities, laboratory tests, medical services. But then again, people in Pangasinan don't feel this," Go added.

The filing also raises questions over how PhilHealth-supported health services are presented to the public under the locally branded GUIConsulta program and asks PhilHealth to clarify whether the local government units may pursue a stand-alone, carve-out or segregated arrangement for funds attributable to their constituents.

At the center of the dispute is the handling of PhilHealth primary-care payments attributed to beneficiaries of the three local government units.

Under the existing arrangement cited by the local government units, only a portion of the amount attributed per beneficiary is made available directly at the local government unit level, while the larger share forms part of the province-wide Special Health Fund arrangement.

The local governments asked PhilHealth and the province to establish through official records how much money was attributable to their residents, how much entered the pooled fund, how much was allocated or spent for their communities, what it was spent on, and how much remains.

"We've been requesting for the itemized list on how it was used with respect to the facilities, if any, laboratory tests, services. But until now, there's still nothing. So that's why we reached out to PhilHealth," Go said.

"We're not assailing or telling that it was stolen. As of right now, what we're saying is, we just want to look into the numbers. What happened to the amount that we're talking about, particularly the P1,360," he added.

Their petition seeks records covering beneficiary counts, PhilHealth remittances, Special Health Fund credits, Provincial Health Board allocations, sub-ledger entries, transfers, releases, obligations, disbursements, deductions, receivables and remaining balances.

It asked PhilHealth to produce and reconcile the records so the local government units—and ultimately the public—can determine what happened to funds attributable to their beneficiaries.

The three local government units are also questioning how PhilHealth-funded benefits are being communicated and branded under GUIConsulta.

Their petition specifically asks that communications involving PhilHealth-funded benefits clearly identify PhilHealth and the applicable public financing framework, so beneficiaries can understand the respective roles of PhilHealth, the provincial government and their city or municipal government.

The branding issue has also spilled into social media, where another Guico-branded health product — Guico-C, an ascorbic acid-and-zinc product distributed to GUIConsulta beneficiaries — has generated online discussion.

The provincial government itself publicly addressed comments and allegations circulating on social media regarding Guico-C earlier this month. Governor Ramon V. Guico III personally discussed the product with beneficiaries, while the Province said Guico-C is FDA-registered, was received through donation and that no provincial funds were used for its procurement.

But the public discussion surrounding the product illustrates the broader transparency issue raised by the LGUs: when medicines, consultations and other health benefits are distributed under a locally branded program, which benefits are paid for by PhilHealth, which are funded or provided by the province, and what do the official financial records show.

For the three local government units, those questions should be settled by documents rather than competing political claims.

They are asking PhilHealth for a certified reconciliation establishing: how much was attributable to each local government unit, how much entered the province-wide pool, how much was released, allocated or spent for their constituents, what was the money spent on, and how much remains attributable to each local government unit.

The petition also asked PhilHealth to determine whether Bayambang, Urdaneta City and Malasiqui can pursue lawful financial separation through stand-alone provider status, an LGU-specific capitation carveout or another segregated accounting and payment mechanism.

The local government units stressed that the dispute should not interrupt healthcare services. PhilHealth benefits, referrals, emergency care and other essential health services should continue while accounting, reconciliation and any eventual restructuring are being resolved.