“Abusive” docs to soon lose PhilHealth Accreditation

Unethical and abusive practices of a physician may soon be included among the offenses that would warrant the cancellation of the accreditation of a health care provider from PhilHealth Insurance Corporation.

Lawyer Valentin Guanio, senior vice president for legal services of PhilHealth, said this new move of the company is done to stop or curb the abuses of some health care providers at the expense of PhilHealth members.

“The integrity and competence of the health care professionals are among the very important elements that patients consider before seeking treatment…these are compromised by a doctor’s unethical practices, …, the patient’s health will be at risk,” Guanio said.

PhilHealth is now investigating reports of abuses by some physicians who conduct medical missions but have their expenses reimbursed through accredited hospitals in their area.  Should these unethical practices are found done by these physicians, their accreditation with PhilHealth would be revoked. “Without PhilHealth accreditation, these doctors can no longer file for reimbursements,” said Guanio.

Guanio said PhilHealth is still working closely with specialty societies to define the parameters of what may be considered ‘unethical’ and already beyond the bounds of moral and ethical practice.

He said penalties for such offenses will similarly be increased and other policy changes will soon be introduced to further strengthen PhilHealth’s campaign against abuse of medical authority.

Philhealth is a premier government corporation that ensures sustainable, affordable and progressive social health insurance to all Filipinos. PhilHealth replaced the Medicare program for government and private sector employees, with its landmark transfer from the Government Service Insurance System (on October 1997) and Social Security System (April 1998). — Ferliza C. Contratista/RAE