PhilHealth slackens requirement of 150 accredited hospitals

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Friday, August 8, 2014

ONE hundred fifty public and private hospitals stand to get their accreditation from the Philippine Health Insurance Corporation (PhilHealth) after the latter simplified its requirement for accrediting medical facilities.

In a press conference for the launching of the Hospital Accreditation Commission (HAC), PhilHealth President and CEO Alexander Padilla said that the remaining 150 hospitals still not accredited by the agency but have been given licenses to operate (LTOs) by the Department of Health (DOH) now stand to get their accreditation.

"All they have to do is sign the 'performance commitment' that we will require from them and we will give them the ‘basic accreditation’ of PhilHealth and they can now be eligible for reimbursement of hospital expenses and professional fees," said Padilla.


The move comes after the DOH decided to make LTOs tantamount to PhilHealth accreditation.

In the past, Padilla said, securing an LTO from the DOH is a different endeavor from getting PhilHealth accreditation.

Under the performance commitment, the concerned hospitals shall vow to meet the long-standing criteria of PhilHealth in accrediting hospitals such as having enough medical personnel, hospital beds, facilities and equipment, and patient safety assurance, among others.

"If they don't meet those commitments, we will be getting back at them," warned Padilla but failed to elaborate.

Of the estimated 1,600 hospitals across the country, the DOH noted that only about 150 hospitals are still not accredited by PhilHealth, majority of them are in rural areas.

Meanwhile, DOH Undersecretary Ted Herbosa said the establishment of HAC provides hospitals – private or public – that are looking to get the "advanced participation" accreditation from PhilHealth the third-party accreditation body that will approve their applications or not.

He said that there has been a clamor from stakeholders to rid the PhilHealth of the sole authority to survey and accredit hospitals looking to avail of its benefits.

"Hopefully, this will encourage more hospitals to apply for 'advanced participation' accreditation from PhilHealth," said Herbosa.

Padilla said those who will be applying for "advanced participation" beginning February 2015 stand to receive additional benefits compared to those under "basic participation".

He said such benefits may range from faster reimbursements, being model facilities for new case-rate packages, and, possibly, additional fee coverage than in "basic participation" facilities.

For his part, HAC Vice Chairman Dr. Tomas Maramba said they expect about 200 to 300 medical facilities to comprise the initial batch of applicants for the "advanced participation" accreditation.

"These are those who are already declared 'Center of Excellence', 'Center of Quality' hospitals that we already have," said Maramba.

Among the members of the HAC, which was created by DOH Administrative Order No 2013-0002, are DOH, PhilHealth, Philippine Medical Association, Philippine Hospital Association, and Private Hospital Association of the Philippines, among others. (HDT/Sunnex)

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