The Philippine Health Insurance Corp. (PhilHealth) said Tuesday it has already liquidated almost 100% of advanced payments to hospitals and other health facilities through its controversial interim reimbursement mechanism (IRM).
“Out of the P14.97 billion releases of PhilHealth for the IRM, we’re able to liquidate around P14.89 billion equivalent to 99.49%,” PhilHealth acting vice president for fund management sector Emily Roque said during the virtual House committee on health hearing.
The PhilHealth official said the state insurer is targeting to liquidate 100% of the IRM funds by September 30, 2021.
The IRM is a system where PhilHealth pays hospitals and healthcare facilities in advance for insurance claims, to ensure that they could function during times of crisis.
Roque said the PhilHealth is coordination with its regional offices to ensure that full liquidation will be attained on September 30.
At the same time, she said the Commission on Audit is conducting a series of audits on the IRM liquidation on all the PhilHealth’s regional offices.
“We have to ensure the full liquidation of this amount and monitor the basis of the liquidation vis-a-vis the unpaid claims,” she added.
The PhilHealth defines the IRM as “a special privilege for the provision of substantial aid to an eligible Health Care Institution directly hit by a fortuitous event with clear and apparent intent to continuously operate and/or rebuild the HCI in order to provide continuous health care services to adversely affected Filipinos.”
However, throughout the course of the congressional investigations last year, it was found that IRM funds were also transferred to dialysis centers, infirmaries, and maternity centers even as they could not be considered as responding to “fortuitous” events.
PhilHealth has since suspended its IRM system “to review its overall implementation and resolve issues arising from congressional inquiries.”
Resigned PhilHealth anti-fraud officer Thorsson Montes Keith has claimed that the PhilHealth “mafia,” composed of the executive committee, stole some P15 billion through fraudulent schemes, including those involving the IRM.
PhilHealth has denied such claims.—AOL, GMA News
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