UST Hospital in DEEP FINANCIAL TROUBLE blames PhilHealth for 180 million pesos 2019 collectible

UST Hospital is claiming a 5 to 6 month processing of claims by PhilHealth. This happened BEFORE the COVID 19 pandemic. This is another proof of the INCOMPETENCE and INEFFICIENCY of PHIC. This is NOT an ISOLATED case of a single hospital crying out for help. Both private and government hospitals are suffering from the same PHIC problem in varying amounts of accounts receivable from the government health insurance organization. The bureaucratic slow movement of paper in PHIC is compounded by the recent scandal of insurance fraud pertaining to a hemodialysis out patient facility. This expose sent shivers done the spines of PHIC executives now in a state of corporate paralysis due to fear of legal entanglements.

During normal times, hospitals just accepted PHIC red tape with a grain of salt but now that we are in the midst of a pandemic, the costs of PPEs (personal protective equipment) and manpower (frontliners are provided food, shelter and transportation not done before this pandemic) have skyrocketed at the same time that major hospital income generating units are closed.

Since the start of the Duterte Administration on June 30, 2016, there have been 5 PHIC Presidents – Aristoza, Dineros, de la Serna, Ferrer and Morales (current) which is termed in business parlance as a revolving door which does not bode well in terms of stability, consistency and long term strategy.

19 ust

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UST Hospital retrenches workers, cites losses, P180M owed by PhilHealth

UST HOSPITAL has cut its manpower amid heavy financial losses since the start of the Covid-19 pandemic. Hospital medical director Dr. Marcellus Francis Ramirez said state-run Philippine Health Insurance Corp. owed more than P180 million in expenses for patients last 2019.
“[P]ainful decisions were needed to be made. While the news around significantly highlights the health and medical impact of the pandemic, the huge economic and financial impact brought about by this crisis to all business establishments, most especially to healthcare institutions, is often overlooked,” Ramirez told the Varsitarian.

Earlier, Ramirez said some patients were discharged on promissory notes.

He said the retrenchment plan “was reviewed in detail by our Legal Counsel and after we have complied with all legal requirements for the same, such as the notification to the Department of Labor and Employment (DOLE) and the 30-day notice to the affected employees.”

“[W]e first implemented non-renewal of fixed term contracts and recently, retrenchment, which, based on our collective bargaining agreement (CBA), would be based on the principle of last in first out,” he said.

He pointed out that retrenchment is a “recognized valid and legal management measure and it remains as such even during the Covid 19 crisis.”

Ramirez said employees affected by the retrenchment measures would receive a 150-percent separation pay based on the hospital’s CBA, which was 50 percent higher than what the Labor Code provides.

Online labor protest on Labor Day

The Ugnayang Nagkakaisang Manggagawa–University of Santo Tomas (UNM–UST) protested what it said was the “wrongful termination” being implemented by the hospital management, supposedly in the guise of business losses.

It said USTH hospital workers remained committed to their work even after their pleas for additional benefits during the pandemic “fell on deaf ears.”

An employee from the Hospital affected by the retrenchment measures said he pleaded with the hospital administrators to keep his job, as looking for another job would not be possible amid the pandemic.

“Kahit na pakiramdam ko wala na ako magagawa sana talaga may maisip pang paraan,” the employee told the Varsitarian.

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Statement from UST Hospital:

The UST Hospital was constrained to implement manpower reduction measures in order to minimize its expenses and to reduce the significant losses it had been sustaining due to the Covid 19 crisis. Since the start of the pandemic and the enhanced community quarantine (ECQ) and lockdown that followed, the overall hospital census went significantly down. Moreover, most of the patients admitted were CoVid patients. Ordinary and elective patients stayed away from most hospitals even up to now due to fear of possible Covid 19 infection. While the news around significantly highlights the health and medical impact of the pandemic, the huge economic and financial impact brought about by this crisis to all business establishments, most especially to healthcare institutions, is often overlooked. The huge cost brought about by our contingency measures to address the demands of the pandemic, which included cancellation of elective procedures and admissions to give way to the intensive care of CoVid patients, as well as the tremendous impact on our patient census, is taking a very serious toll on the hospital’s sustainability.

While Philhealth has instituted healthcare coverage of admitted CoVid patients, reimbursement is delayed by an average of 5 – 6 months. Currently the receivable of USTH from Philhealth stands at more than P180 million and counting.

Despite the foregoing, the hospital continues to operate and pay utilities, (electricity, water, and communications, etc.) services (security and janitorial services and waste management, etc), medications and supplies needed for patients, and for the salaries of employees most of whom are on leave.

Many of the employees also could not come to the hospital because of limited transportation while others filed for unused leaves. There were even some who were not allowed by their parents and family members to report for work.

We have no idea when our operations will return to normal and we are uncertain if we can actually fully operate within the year.

The new normal, as it is called and which we are gradually transitioning into, will not be an assurance that the hospital’s current manpower will still be the number needed to operate it. Painful decisions were needed to be made. In view of the enormous impact of the pandemic, USTH has to implement the right-sizing of its non-crucial (non-frontliner) manpower complement, in addition to other measures which included adjustment of operating hours and implementation of other cost efficiency measures.

We first implemented non-renewal of fixed term contracts and recently, retrenchment, which, based on our collective bargaining agreement (CBA), would be based on the principle of last in first out. The retrenchment was implemented after it was reviewed in detail by our Legal Counsel and after we have complied with all legal requirements for the same, such as the notification to the Department of Labor and Employment (DOLE) and the 30-day notice to the affected employees. Employees affected by the retrenchment measures will receive 150%  separation pay based on our CBA, which is 50% higher than what the Labor Code provides. It must also be noted that retrenchment is a recognized valid and legal management measure and it remains as such even during the Covid 19 crisis.  Thank you for allowing us to clarify about the matter.

Marcellus Francis L. Ramirez, MD

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Related Story:

Private hospitals struggle due to PhilHealth failure to pay arrears

Published March 28, 2020 5:27pm
Private hospitals in the country were struggling to respond to the coronavirus disease 2019 (COVID-19) pandemic as they were running out of funds due to the failure of state-run Philippine Health Insurance Corp. (PhilHealth) to pay its arrears.

This was alleged by University of the Philippines Executive Vice President Teodoro Herbosa in a Facebook post.

“The other reason private hospitals are tapping out is that PhilHealth hasn’t paid last year’s arrears. PhilHealth should release those payments to services already rendered. Bakit iniipit?” Herbosa asked.

“I discovered one of the private hospitals has [P]500 million in collectibles with PhilHealth,” he added.

Asked to comment, Private Hospitals Association of the Philippines Inc. (PHAPI) President Rustico Jimenez confirmed that PhilHealth had not been paying hospitals’ claims on time.

The PHAPI chief added that the state health insurer had around P4 billion to P5 billion in payables to private hospitals.

Herbosa said PhilHealth should start paying even 50% of its arrears to hospitals “on the condition that they continue serving the public whether just a PUI or confirmed COVID 19.”

Sought for comment, PhilHealth Vice President for Corporate Affairs Gigi Domingo said the state health insurer had made available P30 billion in financial assistance to respond to the COVID-19 threat.

“The amount they can avail is three months’ worth of total claims last year. This will address their current needs in providing quality care to all Filipinos in need of hospital services during this COVID pandemic,” Domingo said.

PhilHealth said the release of P30 billion utilizes its interim reimbursement mechanism (IRM) which will provide health care providers with much-needed liquidity to adequately respond to the pandemic.

The arrangement is also part of PhilHealth’s efforts to reduce return-to-hospital payables filed in 2019 and earlier, and to further increase payments to hospitals, the agency said. — DVM, GMA News

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PhilHealth owes billions to private hospitals – exec

Jamaine Punzalan, ABS-CBN News

May 08 2018

MANILA (UPDATE) – The Philippine Health Insurance (PhilHealth) owes billions to private hospitals across the country, a leader of the medical community claimed Tuesday as the agency faced investigation for alleged anomalies.

Dr. Rustico Jimenez, president of the Private Hospital Association of the Philippines (PHAP), said the agency’s debt ballooned after it ordered hospitals to apply for reimbursement claims through an online portal.

“Ang sabi nila, ‘pag ginamit namin ang e-claims, mas mapapabilis po ang bayad. Ngayon po, ang nangyari lalo pong na-delay ang bayad namin. Hindi po makapasok sa kanilang portal e,” he told DZMM.

(They said if we use e-claims, the reimbursement will be quicker. But the delay in payments worsened instead. We can’t even enter their portal.)

Some hospitals may shut down or refuse non-emergency patients if PhilHealth does not settle its alleged debts soon, Jimenez warned.

“Kung hindi pa po magbabayad ang PhilHealth by this time, or 2 weeks’ time, baka marami nang magsara. Baka mag-ano na po kami, hospital holiday,” he said.

(If PhilHealth does not pay by this time, or in 2 weeks’ time, many hospitals may close. We may impose a hospital holiday.)

“Baka hindi na po namin tanggapin ang patients ng PhilHealth kasi po wala nang ipangtutustos ang ospital… Iyung mga emergency po tatanggapin namin iyun, pero iyung mga elective — iyung mga hindi naman po kailangan admit-in, check-up lang — siguro ibibigay na lang po namin iyun sa government hospitals,” he added.

(We may also stop accepting PhilHealth patients because hospitals no longer have funds. We will only accept emergency cases and refer elective ones — those who won’t be admitted and only need check-up — to government hospitals.)

Jimenez’s accusations came in the wake of President Rodrigo Duterte’s order to investigate the P627,000 in travel expenses allegedly incurred by PhilHealth officer-in-charge Celestina Ma. Jude Dela Serna in 2017 — the same year that her agency reported an unaudited loss of P9 billion.

PhilHealth will check if it has failed to process hospital claims within the required 60 days, said the agency’s OIC-Vice President and head executive assistant, Dr. Israel Francis Pargas.

“We will do our thing and check kung iyung mga sinabi niya (PHAP’s Jimenez)… and we will see what we can do kaagad-agad para d’yan,” Pargas said in a separate DZMM interview.

(We will do our thing and check his statements… and we will see what we can do immediately do about that.)

Pargas said the agency is working on the technical difficulties of its online portal.

“There are issues right now we are trying to solve but hopefully this particular use of technology would actually result in a more efficient processing not only for PhilHealth but also for the facilities for filing their claims,” he said.

Pargas, meanwhile, admitted that the agency currently has a backlog in processing claims by private hospitals.

“Yes, we do owe…In some of our offices, in some of our regions, we have a recorded backlog in the processing of our claims but Dr. Jimenez is saying names of facilities so we would like technically to check those facilities,” he said.

Malacañang will also look into the Jimenez’s accusation, vowed Presidential Spokesperson Harry Roque.

“Ito naman po ay iimbestigahan din ng ating Palasyo at kaunting panahon lang po, dahil itong mga balitang ito ay kakaputok lang din po,” he also told DZMM.

(This will also be investigated by our Palace. We only need a little time because this news has just broken.)

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