THE decision to shut down operations is the hospital management’s call, and not of the government.
The Philippine Health Insurance Corporation (PhilHealth) today said that the Bacolod Our Lady of Mercy Specialty Hospital (BOLMSH) may file a motion for reconsideration (MR) of their denied accreditation within 30 calendar days.
Aside from filing the MR, the hospital may also opt to re-file an application for accreditation at the Regional Office in Iloilo City.
The denial of BOLMSH’s application for continuous accreditation was due to the hospital’s conviction resulting from fraudulent acts committed by the hospital’s previous management, violating pertinent provisions of the National Health Insurance Act of 2013.
In a conference with PhilHealth Region VI officials, the hospital management has signified that they will no longer seek reconsideration for their accreditation.
Once health care institutions (HCIs) partner with PhilHealth for the implementation of the National Health Insurance Program, they commit to abide by the policies that PhilHealth institutes, and any violation of this commitment may be considered as grounds for the non-renewal of their accreditation.
Due to the non-renewal of BOLMSH’s accreditation, PhilHealth members who seek medical treatment in the said facility will not be able to avail themselves of their social health insurance benefits. Instead, PhilHealth members in Bacolod City are advised to seek medical services in other PhilHealth-accredited HCIs in the city. There are at least five (5) other accredited HCIs in the city where PhilHealth members may avail themselves of their PhilHealth benefits.
The PhilHealth Regional Office VI is looking into the hospital management’s appeal for payment of claims filed prior to the issuance of the denial of renewal of accreditation. The Regional Office has posted one of the shortest turn-around-times (TAT) in claims processing nationwide that includes 23 days as of April this year.
Earlier, the state health insurer posted net cash flow of P11.6 billion for the first four months of 2018 or as of April 30, 2018. It recorded cash inflow of P41.4 billion consisting mainly of premium contributions collection at P39.2 billion and investment income at P2.2 billion, higher by more than 104 percent and 10 percent from P19.2 billion and P2 billion, respectively, for the same period in 2017.
The jump in cash inflow was partially attributed to the early partial release of P14.9 billion for the premiums of some 4.7 million senior citizens by the National Government pursuant to the General Appropriations Act of 2018.
On the other hand, expenditures were made up of benefit payouts at P28 billion, and administrative expenses of P1.8 billion which is 22 percent lower than last year's P2.2 billion. (END)
Reference: Dr. Israel Francis A. Pargas, OIC-SVP, Health Finance Policy Sector (Mobile: 0917-8089399)