PHAPI sees more delays in payment after cyber attack on PhilHealth

The Private Hospitals Association of the Philippines Inc. (PHAPI) said it was expecting the payment of hospital dues to take longer after the Philippine Health Insurance Corporation (PhilHealth) was hit by the Medusa ransomware.

PHAPI president Dr. Jose Rene de Grano lamented on the billions of hospital claims that the state health insurer has yet to pay supposedly by December, as promised by PhilHealth president and CEO Emmanuel Ledesma Jr.

“Ngayon nagkaroon ng ganito (cyber-attack), well of course we are expecting na sana matuloy. But then nagkaroon naman ng problemang ganito na down ang buong system ng PhilHealth, then of course we’ll be expecting more delays,” de Grano said.

(We are expecting the payment to push through. But then there was a problem like this that the entire PhilHealth system is down, then of course we will be expecting more delays.)

“Syempre ang iniisip ng mga hospitals na supposedly mababayaran na agad kami ay medyo lumalabo na naman. So, hopefully ma-resolve kaagad nila yan nang sa gayon ay mabayaran agad ang mga hospitals,” he added.

(Of course, the hospitals’ hopes are getting low. So, hopefully, PhilHealth can resolve that immediately so that the hospitals can be paid immediately.)

De Grano earlier disclosed that PhilHealth has yet to pay over P10 billion in claims with private hospitals.

He said that the unpaid claims continue to increase as patients keep coming every day. Also, private hospitals can't refuse to accept patients nor can they not grant PhilHealth benefits as patients might suffer.

The PHAPI president explained that delayed payment will specifically affect the small hospitals than the bigger ones which usually have buffer funds.

“Karamihan sa small hospitals they rely or very dependents on patients na talagang NBB (no balance billing) or charity patients. These patients, halos walang binabayaran. So kung made-delay ang payments at ang processing ng benefits ng ating mga members, mauubos ang pera ng mga smaller hospitals to the point na siguro maapektuhan ang cash flow nila, maapektuhan ang kanilang operations,” he said.

(Most of the small hospitals rely on or are very dependent on patients who have no balance billing or charity patients. These patients almost pay nothing. So if the payments and the processing of the benefits of our members are delayed, the money of the smaller hospitals will be depleted to the point that their cash flow and operations may be affected.)

With this, de Grano said the worst possibility that might happen is that smaller hospitals would have to require patients to shoulder the cost of their hospital bills.

“Initially siguro ay sasabihin nila sa ating mga beneficiaries ay hindi muna naming ide-deduct ng PhilHealth portions and magbayad po muna kayo. Out of pocket lahat po yun. Kase otherwise, we can no longer provide these services,” he added.

(Initially, maybe they will tell our beneficiaries that we will not deduct the PhilHealth portions and that they will pay first. It's all out of pocket. Because otherwise, we can no longer provide these services.)

Prior to the cyber attack, Ledesma said PhilHealth would pay a "high percentage" of its P27 billion worth of hospital dues within 90 days or in December. —NB, GMA Integrated News