Philippine Health Insurance Corp. (PhilHealth) yesterday Apr. 7, released a new case rate package for patients who need to be treated due to COVID-19 starting Apr. 15.
Currently, PhilHealth is paying for all the hospitalization and treatment costs incurred by patients with COVID-19 as President Duterte on Monday, Apr. 6 said, “The PhilHealth shall pay for all COVID-19 tests conducted outside hospitals or in nonhospital facilities, such as laboratories and drive-thrus, provided that the facilities are accredited by the Research Institute for Tropical Medicine.”
Although, PhilHealth President and CEO Ricardo Morales pointed out that while the state health insurer had “sufficient” funds, implementing a certain rate package for COVID-19 patients is needed to ensure the sustainability of the healthcare option.
All Filipinos are covered by PhilHealth under the Universal Health Care Law, but a case rate package should set the maximum amount that the state insurer will pay for the treatment of a patient for a certain ailment. Hospital charges over the set amount would have to be shouldered by the person themselves or through a personal health insurance.
“The PhilHealth fund is sufficient, but it’s not unlimited. That’s why we have to exercise due prudence,” Morales said in a briefing on Tuesday.
Under the new package, coverage for COVID-19 patients is segregated into four categories depending on the gravity of their conditions: (1) coverage for mild pneumonia is set at P43,997, (2) moderate pneumonia at P143,267, (3) severe pneumonia at P333,519 and (4) critical pneumonia at P786,384.
However, some health professionals from several hospitals like VRP Medical Center director Dr. Veronica Regina Garcia said that they have yet to receive any notice from PhilHealth. Morales acknowledges this and claims that he had instructed regional vice presidents and personnel to relay the information to the hospital administrators under their jurisdictions.
He concludes that PhilHealth has already paid out P6 billion from the P30 billion they set aside to pay hospitals that will claim reimbursements for patients covered by the state health insurance system. Nonetheless, he says that PhilHealth was already coordinating with the banks to expedite the fund releases for hospitals.
The new treatment rates will take effect on Apr. 15. While PhilHealth assures that it will still cover all costs incurred by patients prior to that date, many citizens are concerned due to the fact that this kind of limited coverage will be implemented a day after mass testing for PUIs and PUMs are set to launch and more positive cases are to be expected. The extension of the enhanced community quarantine is also something worth bearing in mind.
Header photo courtesy of Inquirer.net
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