LEGISLATORS want a more thorough investigation into the P15.5-billion advance payments made by the Philippine Health Insurance Corporation (PhilHealth) to hospitals under its controversial Interim Reimbursement Mechanism (IRM) program.
During Wednesday’s oversight hearing of the House Committee on Appropriations, several congressmen voiced concerns over the legality and transparency of the IRM program, which was implemented during the previous Duterte administration.
Gabriela Party-list Rep. Arlene Brosas raised critical questions about the IRM, a system that advanced P15.5 billion in funds to private and government hospitals during the COVID-19 pandemic.
“Ang allegation ay P15.5 billion na binulsa umano ng PhilHealth officials through fraudulent schemes? Pinautang sa mga negosyante and hospital owners itong budget na ito para sana sa emergency fund para sa mga natural disasters? Meron na rin ba na naging liable baka maaari na nating makuha ang report nila? (The allegation is P15.5 billion allegedly pocketed by PhilHealth officials through fraudulent schemes? This budget was loaned to businessmen and hospital owners for the emergency fund for natural disasters? Is there anyone who has become liable, maybe we can get their report), ” Brosas said.
The IRM controversy happened during the PhilHealth management under the Duterte administration.
Brosas lamented why PhilHealth officials could not answer some of the questions surrounding the program.
“Dapat may institutional memory ang ating PhilHealth, ‘di ba? Kaya nga natin sila pinapatawag kasi gusto naman natin itahi ang mga nangyari noong nakaraan hanggang ngayon. ‘Yung mga issues na ‘yan, they will hound us (Our PhilHealth should have an institutional memory, right? That’s why we are calling them because we want to stitch together what happened in the past until now. Those issues, they will hound us),” Brosas said.
House Deputy Majority Leader and Iloilo Rep. Janette Garin, meanwhile, questioned the legality of using PhilHealth funds, which are not government funds but rather the contribution of members, as capital for private and government hospitals.
“Ano ba ang ginawa? Ang ginawa noong nakarang administrasyon, ginamit ang pera ng PhilHealth. Ang pera ng PhilHealth hindi ‘yan government funds. Pondo ‘yan ng mga miyembro ng PhilHealth because it’s an insurance mechanism (What was done? What was done in the previous administration, PhilHealth money was used. PhilHealth money is not government funds. That’s a fund of PhilHealth members because it’s an insurance mechanism),” Garin pointed out.
“The first question here, was it legal? And I believe, Madam Chair, that is something this committee should look into kasi dapat iniingatan ng PhilHealth (ang pondo ng mga miyembro),” she added,
“The first question here, was it legal? And I believe, Madam Chair, that is something this committee should look into because PhilHealth should keep (the members’ funds,” Garin said.
Appropriations panel vice chair Marikina City Rep. Stella Quimbo, who presided over the hearing, also raised concerns about the selection process of the facilities that received IRM funds.
“Nagkaroon din tayo ng initial findings na ang pagpili ng facilities na nakatanggap ng IRM ay tila walang naging connection sa COVID patterns. So sino, paano pinili ang facilities na ito? (We also had initial findings that the selection of facilities that received IRM seemed to have no connection to the COVID patterns. So who, how were these facilities chosen?) Quimbo asked.
The committee then decided to summon previous PhilHealth officials to provide more insights into the program.
It was confirmed that PhilHealth’s president and CEO at the time of the IRM’s implementation was Ricardo Morales, a retired army general.
Acting on a motion by Garin, the committee also ordered PhilHealth to submit all pertinent documents related to IRM.
“PhilHealth should provide this committee with all the pertinent documents including minutes of all the meetings conducted related to the conceptualization up to the implementation of the interim reimbursement mechanism,” Garin moved.
The motion also included a request for the names of all officials, whether career or appointed, involved in the program’s formulation.
The oversight hearing was part of an effort to enhance government accountability and efficiency.
Emphasizing the importance of this oversight function, Quimbo said, “This hearing is to ensure the efficiency, effectiveness, and accountability of the national government and all its agencies in the authorized appropriations by Congress as provided under Section 29, Article 6 of the 1987 Constitution.”
The committee thoroughly reviewed the DOH’s accountability reports and fiscal report operations, budget utilization in relation to its targets, performance, and status of the implementation of the Health Facilities Enhancement Program as of fiscal year 2023, as well as the first quarter of 2024.
