The House Committee on Health has launched an investigation into the management of Philippine Health Insurance Corporation (PhilHealth) funds following reports of significant delays in healthcare provider reimbursements and concerns about reserve fund utilization.
Scope of Investigation
Committee Chair Representative Angelina Tan announced that the inquiry will examine PhilHealth's financial management from 2022 to present, focusing on claims processing timelines, reserve fund investments, and benefit package implementation.
Healthcare Provider Complaints
Multiple hospital associations have submitted position papers detailing reimbursement delays averaging 180 days, significantly longer than the mandated 60-day period. Several smaller hospitals reported financial difficulties due to unpaid claims.
"Our members are being forced to choose between maintaining quality care and financial survival. This situation is unsustainable," said Dr. Jaime Galvez Tan, representing the Private Hospital Association.
PhilHealth Response
PhilHealth President Emmanuel Ledesma defended the agency's performance, citing improved processing rates in recent months. He attributed earlier delays to system upgrades and enhanced fraud detection measures.
Reserve Fund Questions
Lawmakers have also questioned the accumulation of reserve funds exceeding PHP 500 billion while members face coverage gaps. PhilHealth officials explained that reserves are maintained as required by law for long-term sustainability.
Next Steps
The committee has scheduled three more hearings before submitting its findings. Legislative recommendations may include amendments to the Universal Health Care Law and enhanced Congressional oversight of PhilHealth operations.
