MANILA, Philippines- Nagamit sana ang P89.90 bilyong excess funds ng Philippine Health Insurance Corp. (PhilHealth) upang palawigin ang benepisyo ng mga miyembro nito, ayon sa Commission on Audit (COA).
Sa 2023 audit report ng state health insurer, sinabi ng COA na nagresulta ang turnover ng hindi nagamit na pondo sa Bureau of Treasury sa “depriving the members of adequate and additional benefit coverage.”
“The Audit Team opined that the unutilized portion of the subsidies from NG (national government) could have been used by PhilHealth to significantly expand its benefit programs provided specifically for indirect contributors such as Senior Citizens, Persons with Disability, marginalized members of the society included in NHTS (National Household Targeting System), and others,” pahayag ng COA.
Sa kasalukuyan ay wala pang komento ang PhilHealth ukol dito.
Nauna nang inatasan ng Department of Finance ang PhilHealth na i-remit ang halos P90 bilyong unused subsidies upang pondohan ang unprogrammed appropriations sa 2024 budget.
Kinuwestiyon naman ito ng ilang grupo sa Supreme Court (SC), na nagsabing dapat gamitin ang pondo para sa benepisyo ng PhilHealth members.
Noong Oktubre, nagpalabas ang SC ng temporary restraining order laban sa paglilipat ng PhilHealth funds sa national treasury.
Sa kasalukuyan, sinabi ng PhilHealth na P60 bilyon na ang nailipat sa national treasury kung saan P29.9 bilyon na lamang ang natitira sa ahensya.
Sa audit findings, inihayag ng COA na hindi buong nakatalima ang pangangasiwa ng PhilHealth Reserve Fund sa Republic Act No. 11223 o ang Universal Health Care Act upang matiyak na lahat ng Pilipino ay may access sa de-kalidad at abot-kayang health care goods at services.
Tinukoy ng COA ang dalawangs salik sa pagpalya ng PhilHealth na tumalima sa batas: una, “investment of funds without considering actuarially estimated two-year projected program expenditures,” at ikalawa, “delayed and minimal expansion of benefit programs and partial utilization of subsidies from the National Government, resulting in the planned return of P89.9 billion unutilized funds to the Bureau of Treasury, thus depriving the members of adequate and additional benefit coverage.”
“Nonetheless, PhilHealth is still required to expand members’ benefits to fully utilize any unused portion of the Reserve Fund, if any, pursuant to Section 10 of the UHC Act which states that for every increase in the rate of contribution of direct contributors and premium subsidy of indirect contributors, PhilHealth shall provide for a corresponding increase in benefits, subject to financial sustainability,” pahayag ng COA.
“To ascertain the implementation and dissemination of information for the new benefit package, the Audit Team requested from certain PROs the amount of benefit claims paid for the Outpatient Benefits Package for Mental Health. The data showed nil amount in benefit claims paid during CY 2023, considering that there is a rising epidemic of mental health crises in the country according to the Philippine Mental Health Association, Inc.,” ayon pa sa komisyon.
Dagdag ng COA, “From the cash flow analysis, it can be deduced that the Corporation is not prioritizing the expansion of its benefits programs to achieve its mandate, as most funds are allocated for investing activities.” RNT/SA
