Dialysis coverage ng PhilHealth pinatataasan ni PBBM sa 156 sesyon

Dialysis coverage ng PhilHealth pinatataasan ni PBBM sa 156 sesyon

March 9, 2023 @ 9:10 AM 2 weeks ago


MANILA, Philippines – Ipinag-utos ni Pangulong Ferdinand Marcos Jr. sa  Philippine Health Insurance Corp. (PhilHealth) na palawakin ang sakop nito upang mabigyan ng mas maraming benepisyo ang mga miyembro nito.

“Marcos met PhilHealth officials led by its acting president and CEO Emmanuel Ledesma Jr.,  to discuss its short-term plan in the first six months of 2023 during a meeting at Malacañang Palace,” ayon sa Presidential Communications Office (PCO).

Kabilang sa mga plano ay itaas ang  hemodialysis coverage mula 90 hanggang 156 sessions, pagpapawalang-bisa sa “pay-whichever-is-lower corporate policy” sa  pagbabayad ng claims at itaas ang case rate ng top four packages sakop ang 25% ng filed claims.

Sinabi ng PhilHealth na itataas nito ang  dialysis support  ng tatlong beses isang linggo para sa mga outpatients, katumbas ng  full weekly coverage annually  sa pinalawak na coverage nito.

Sinabi pa na isasama rin dito ang pagpapakilala sa PhilHealth mobile app at short message service (SMS) confirmations, at maging ang implementasyon ng  bagong  benefit packages.

Sa ilalim ng bagong packages nito,  sinabi ng state health insurer na tinitingnan nito na umpisahan din ang “outpatient mental health benefit package, outpatient package for severe acute malnutrition for children below five-years-old, and strengthen its Konsulta package.”

Plano rin ng PhilHealth na i-rationalize ang COVID-19 in-patient packages, i-reverse ang transcription polymerase chain reaction (RT-PCR), at rapid antigen tests at maging ang isolation packages.

“It said that it 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 three percent interest on missed premium payments for its mid-term plan to be introduced in 2024,” ayon sa ulat.

Plano pa rin ng state health insurer na magpatupad ng penalty sa mga pasaway na doktor at  mga ospital sa halip na bawiin ang kanilang
accreditation, amyendahan ang Universal Healthcare Law (UHC), at itaas ang case rates ng top 10 packages na mayroong  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,” ayon sa PhilHealth.

“For its long-term plans, PhilHealth will be pursuing digitalization and the construction of PhilHealth-owned buildings and facilities,” dagdag na  pahayag nito.

Nauna rito, sinabi ng PhilHealth na nagbayad ito ng P66.3 bilyong halaga ng claims para sa  COVID-19 patients.

Sakop naman ng PhilHealth ang  hospitalizations ng COVID-19 patients  depende sa kalubhaan ng pneumonia, mula  P43,997 hanggang  P786,384. Kris Jose