President Ferdinand R. Marcos Jr. directed on Wednesday the Philippine Health Insurance Corp. (PhilHealth) to expand its coverage for its members.
During a meeting with the President at Malacañang Palace, PhilHealth officials led by its acting president and CEO Emmanuel Ledesma Jr., spelled out its short-term plan (first six months of 2023) such as increasing the hemodialysis coverage from 90 to 156 sessions, repealing the pay-whichever-is-lower corporate policy in payment claims and increasing the case rate of the top four packages covering 25 percent of filed claims.
With its widened dialysis coverage, PhilHealth will increase dialysis support to three times a week for outpatients, equivalent to full weekly coverage annually.
Also part of the state health insurer’s short-term plan is the introduction of PhilHealth mobile app and short message service (SMS) confirmations, as well as implementation of new benefit packages.
Under its new packages, PhilHealth is looking to introduce the outpatient mental health benefit package, outpatient package for severe acute malnutrition for children below five years old and strengthen its Konsulta package.
PhilHealth also plans to rationalize the Covid-19 in-patient packages, reverse transcription polymerase chain reaction (RT-PCR) and rapid antigen tests as well as isolation packages.
For its mid-term plan to be introduced in 2024, PhilHealth will carry out general amnesty for employers and government agencies with missed premium payments, which will cover businesses, employers and individuals, especially small and medium enterprises that cannot afford to pay the 3 percent interest on missed premium payments.
The health insurer also plans to impose penalties on erring doctors and hospitals instead of revoking their accreditation, amend the Universal Healthcare Law (UHC) and increase the case rates of top 10 packages with the highest claims filed.
An anti-fraud system will also be introduced and a reorganization of PhilHealth will also be implemented to ensure proper manpower complement, especially for claims processing and frontline services.
For its long-term plans, PhilHealth will be pursuing digitalization and the construction of PhilHealth-owned buildings and facilities. (PND)
