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PhilHealth: "Incentives Not Excessive, Irregular and Anomalous" October 18, 2013

The Philippine Health Insurance Corporation (PhilHealth) has acknowledged the findings of the Commission on Audit on its various allowances given its officers and employees amounting to P1.5 billion in 2012, but said it has strong legal basis in doing so.

In a press conference held in its head office in Pasig City, the state-run health insurance agency assured its 81 million members that it has been prudent in the use of their hard earned contributions.

"The bonuses and incentives are above board, not irregular, not extravagant and most of all, well deserved by the hardworking employees of PhilHealth", PhilHealth Vice President for Corporate Affairs Dr. Israel Francis A. Pargas said in a statement, adding that the incentives were made possible due to good performance as well as the good relations between Management and the employees.

PhilHealth has 5,806-strong workforce in 2012, the subject year of the COA report.

Pargas clarified that the P1.5 billion in question is “not all worker bonuses as it includes maintenance and other operating expenses such as representation and committee expenses are regular expenses used in the discharge of regular functions” and therefore not considered allowances.

He reiterated that PhilHealth has been given the proper authority to fix the compensation of its personnel even without prior approval of the Office of the President of the Philippines pursuant to Section 16.n of Republic Act 7875 as amended.

The said law explicitly authorizes us "to fix the compensation of our personnel as may be deemed necessary and upon the recommendation of the president of the Corporation", he emphasized, adding that "this is strong legal basis which does not need prior approval of the President of the Republic".

Pargas said that PhilHealth is given until mid-November this year to respond point-by-point to the COA findings.

Shortfall on reserves, delayed claim payments

PhilHealth also clarified COA’s claim of shortfall in its reserves, saying that the expanded membership and enhanced benefits have positively impacted in the sense that the monies are now being put to good use for the benefit of contributors themselves. PhilHealth expects to pay some P64 billion in benefit claims for this year.

"The two years reserve is more of a limitation or a ceiling than a minimum or floor. The law says that we should not have more than two years of reserves and we need to reconcile this with COA", Pargas explained.

Disputing the old-age issue of delays in paying hospitals, the state-run agency reiterated that the matter has already been addressed in the past. To date, its average turnaround time for claims processing across all regions is already below the 60 days sanctioned by the law. "We know that there is a need to do more that is why we are shifting to case-based payments and investing heavily on information technology to electronically process claims and put this issue to rest", he assured.

Pargas also reacted to the alleged inaction on some P250 million which remained unclaimed since 2007, saying that contrary to reports, PhilHealth has been exerting efforts to inform members of their refunds through radio announcements, publication even in its social media platforms, and direct notifications. END

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