The Anti-Red Tape Authority (ARTA) said on Tuesday, Sept. 7, that it is forming a technical working group (TWG) to help the Philippine Health Insurance Corporation (PhilHealth) in streamlining unpaid COVID-19 claims by public and private hospitals.
This, as ARTA’s meetings and hearings with PhilHealth and private stakeholders, reveal bigger issues that require a whole-of-government approach.
Secretary Jeremiah Belgica, ARTA Director-General, said members of the Department of Health (DOH), Food and Drug Administration (FDA), Health Technology Assessment Council (HTAC), Department of Information and Communications Technology (DICT), and other key agencies will form the group.
“Kailangan magtulungan po tayo dahil iisang gobyerno tayo. Matatalo natin ang COVID-19, na patuloy na nagpapahirap sa mga kababayan natin, kung tutulungan natin ang isa’t isa,” Belgica said.
PhilHealth has come under fire for the delays in its payment of COVID-19 reimbursement claims from both public and private hospitals.
In a hearing on Sept. 1, 2021, among some of the issues raised were the non-coverage of Remdesivir and Tocilizumab, medicines used to treat COVID-19 patients, by the Standard of Care.
Previous hearings between ARTA and PhilHealth also revealed that the state insurer has issues with its Information and Communications Technology (ICT), wrong diagnoses and faulty documentation in its Return-to-Hospital applications, and Medical Prepayment Review (MPR).
Earlier, the Authority connected PhilHealth with the DICT that pledged to assist them with their storage concerns. However, the state insurer will have to resolve its internet speed issues on its own since it will be coordinating with its internet service provider.
Belgica also advised PhilHealth to rid their systems of redundant processes and push Congress to legislate their streamlining efforts so that they will have a legal cover.
Further coordination will be made with PhilHealth, other key agencies, and private stakeholders to discuss the TWG. – bny
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