IN a statement, Cagayan de Oro City 2nd District Rep. Rufus B. Rodriguez urged the House of Representatives to investigate PhilHealth's failure to pay P59.6 billion in hospital claims, today, January 31, 2025.
This issue, highlighted in his Resolution No. 2173, is affecting medical services across various hospitals.
Rodriguez pointed out that these unpaid claims have led to some hospitals partially or fully closing their services.
As a result, many workers have lost their jobs, which is harmful for PhilHealth members needing medical care.
He pointed out the need for an inquiry into the non-payment of these claims and suggested that the health committee take action.
PhilHealth Senior Vice President Renato Limsiaco informed lawmakers that in 2024, there were 483,000 denied claims amounting to P4.7 billion, while from 2018 to 2023, around three million claims totaling P32.4 billion were rejected.
The Department of Health reported that most of the claims were denied because hospitals failed to file them within 60 days as required by law.
Limsiaco also stated that PhilHealth had a cash-on-hand amounting to P492 billion as of December 31 last year.
According to Rodriguez, the Department of Budget and Management reported that PhilHealth has access to significant funds, including P150 billion in surplus reserve funds, P203 billion in estimated premium collections for 2025, P80 billion in unfunded allotments for 2023 and 2024, and P21 billion in unreleased appropriations.
Rodriguez emphasized that even with these accessible funds, the unpaid P59.6 billion is causing severe problems for hospitals and the patients they serve.
