MANILA, Philippines – Aamyendahan ng Philippine Health Insurance Corporation (PhilHealth) ang 24-hours confinement policy nito, o ang required minimum hours ng hospitalization o confinement ng emergency outpatients, pagsapit ng Disyembre 2024.
Ayon kay Eli Dino Santos, PhilHealth Executive Vice President at Chief Operating Officer, nitong Miyerkules, Oktubre 2, gumagawa na ang ahensya ng mga polisiya kaugnay sa coverage ng emergency outpatient cases na walang inoobligang minimum number of hours ng hospitalization o confinement.
Ani Santos, kasalukuyan ay hindi sakop ng Philhealth ang confinements na mas mababa sa 24 na oras, maliban sa emergency cases o kung mayroong indikasyon na sakop ito dahil sa cross-containment at fraud prevention measures.
“If we indiscriminately allow coverage, financial coverage for all visits to the emergency room, this might promote immoral hazard, abuse in short,” sinabi ni Santos sa mga senador kasabay ng joint hearing ng Senate committee on health and demography, at committee on finance.
Sa PhilHealth Circular 2020-0007, ang 24-hours confinement rule ay tumutukoy sa “the compensability of a claim based on the required minimum number of hours of hospitalization or confinement for inpatient care in an accredited healthcare institution.”
Iginiit naman ni Senador Christopher “Bong” Go, na chairman ng Senate committee on health and demography, na ang 24-hours confinement policy ay “anti-poor” at “anti-people.”
“Itong outpatient services, hindi cino-cover ng PhilHealth? Bakit hindi niyo ito i-cover, napansin ko, kailangan i-admit muna ng isang araw para i-cover ng PhilHealth. Mas gastos ‘yun, kasi magbabayad sila sa kuwarto,” ani Go.
“Majority, almost all ng pupunta sa emergency, may sakit ‘yan. Kaya kailangan natin dito, prevention, hindi lumala ‘yung sakit, mas maagapan natin ‘yung sakit, mas makakatipid ang PhilHealth, at malaking tulong ‘yun sa mga ordinaryong miyembro ng PhilHealth,” giit pa niya.
Dahil dito ay hiniling ni Go kay Santos na linawin an timeline sa pag-amyenda sa kanilang mga polisiya.
“Itong emergency outpatient services, ico-cover na po ito ng PhilHealth? So ‘pag pumunta sila sa ospital, hindi na nila kailangan magpa-admit, ng 24 hours para ma-cover ng PhilHealth ang kanilang babayaran sa ospital? Tama ba, ito co-cover na ba bago matapos ang taon?” tanong ni Go.
Sumagot naman si Santos at sinabing, “We committed already, and our President and COO have already presented a timeline for this year, and we committed to craft or develop an emergency care package by December of 2024.” RNT/JGC
