Lawmaker airs concern over new PhilHealth case payment system

AGHAM Party-List Rep. Angelo B. Palmones questions the implementation of the new policy on the availment of medical benefits by PhilHealth members without the proper public hearing or consultation with beneficiaries and stakeholders.

“Under the new scheme called “case rates payment”, PhilHealth identified 22 medical and surgical cases with fixed rates or fixed amounts to be paid directly to hospitals and clinics,” Palmones explained.

The covered cases are dengue 1, dengue 2, pneumonia 1 and 2, essential hypertension, cerebral infarction (CVA I), Cerebro-vascular accident hemorrhage (CVA II), acute gastroenteritis (AGE), asthma, typhoid fever, newborn care package (NCP), radiotherapy, hemodialysis, maternity care package (MCP), delivery by ceasarian section (CS), appendectomy, cholecystectomy, dilatation and curettage, thyroidectomy, herniorrhapy, mastectomy, and hysterectomy.

Palmones said that for these cases, the fixed rates range from P1,750 to P38,000.

He aired concern that the new scheme could be good for short period of confinement only. He also added that PhilHealth members should be given the opportunity to be informed and heard on the new policy, especially the less privileged.

“While we understand that the new scheme is for the best interest of the public, it would be better to get their side or opinion because they will be most affected by this new policy,” Palmones added. AGHAM, Vicky B. Bartilet