ARTA issues show-cause order to 2 PhilHealth officials over unpaid hospital claims

THE ANTI-RED Tape Authority (ARTA) issued a show-cause order against two Philippine Health Insurance Corp. (PhilHealth) officials over the state-owned company’s failure to release the payment for claims of seven hospitals in Iloilo City.

ARTA said in a statement on Tuesday that the total amount claimed by the seven medical facilities is at least P690.02 million, and were supposed to have been paid by the end of October.

According to ARTA, it issued a show-cause order against Alfredo Pineda III, PhilHealth area vice president, and Valerie Anne Hollero, PhilHealth regional director.

The two PhilHealth officials are given seven working days from the receipt of the order to clarify the delay in payment.

If their responses are deemed insufficient, they may face charges for violating Republic Act No. 11032 or the Ease of Doing Business and Efficient Government Service Delivery Act of 2018.

The seven hospitals are: Iloilo Mission Hospital, St. Paul’s Hospital of Iloilo, Iloilo Doctors’ Hospital, Medicus Medical Center, The Medical City of Iloilo, Qualimed Hospital Iloilo, and the Metro Iloilo Hospital and Medical Center, Inc.

ARTA Director General Jeremiah B. Belgica said the two officials should explain the delayed release of the claims, adding that PhilHealth offices should comply with the 60-day processing period.

“We want them to explain why they have not paid the hospitals yet. Considering that it is a long time ago, they should’ve paid already. They should just pay and do a very efficient post audit afterwards,” Mr. Belgica said.

“For whatever policy or actuarial reason, the hospitals should not be made to suffer because all of their suffering ultimately redound to the disadvantage of the people serviced by hospitals,” he added.

Private Hospitals Association of the Philippines, Inc. President Jose Rene de Grano earlier said several of their members in different parts of the country are already planning to disengage from the state-owned insurer after failing to collect unpaid claims as of end-Oct. — Revin Mikhael D. Ochave