Alan Cayetano: PhilHealth package benefits needs updating

Senator Alan Peter Cayetano said it is time for the Philippine Health Insurance Corporation (PhilHealth) to update its packages to account for high inflation that has driven up healthcare costs.

But in order to update PhilHealth packages to current healthcare expenses, fine-tuning PhilHealth’s No Balance Billing (NBB) policy is a must.

“If you ask me about the rising cost of rice or oil, I can respond to that. But you need to tell, are the laboratory fees or hospital fees also increased? We want to focus on zero billing kasi iyon talaga ang isyu (That is really the issue),” Cayetano told PhilHealth officials during the Senate Committee on Government Corporations and Public Enterprise’s briefing on Wednesday, October 5, 2022.

He said in order to update PhilHealth packages to current healthcare expenses, there is a need to fine-tune its No Balance Billing (NBB) Policy.

“We are interested in zero billing. How do we address the issues kung passé na y’ung amount? Right now kasi napakalaki ng inflation,” Cayetano said.

The NBB policy, also known as zero billing was introduced by PhilHealth in 2012. Under the policy, no other fees are charged to or paid for by members for health services rendered by government hospitals or select PhilHealth accredited private hospitals.

PhilHealth’s All Case Rates (ACR) Policy, which refers to the fixed amount that it reimburses members for specific cases or illnesses, was introduced by the state health insurance agency in 2012.

But with a decade passing since both policies have been implemented, it may be high time to adjust PhilHealth’s packages.

Aside from zero billing, Cayetano also expressed interest in tackling PhilHealth’s access and service coverage.

“We’ll also be focusing on PhilHealth’s access and coverage because what if they offered services that is complete and nice but there are no PhilHealth-accredited hospitals in that area? Forty percent of our barangays do not even have primary health centers,” he noted.

But he assured PhilHealth officials that despite the gaps that need to be filled, he is not blaming the agency.

“We just want to address the gaps,” he said.