Iloilo City Mayor Jerry P. Treñas has filed a complaint before the Office of Ombudsman and the Anti-Red Authority against Philippine Health Insurance Corporation (PhilHealth-6) officials for allegedly failing to settle hospital claims amounting to almost P1 billion.

In his complaint letter dated Aug. 26, Treñas sought an investigation into the delayed release of reimbursements, which has reached a total of P932.322 million as of August 24, to nine hospitals and the city government-run Uswag Molecular Laboratory.

Respondents in the complaint are PhilHealth-6 regional vice president Atty. Valerie Anne H. Hollero, Health Care Delivery Management Division chief Marjorie A. Cabrieto, and Claims Processing officer-in-charge Dr. Genaline Aguirre.

Treñas said the three must be held accountable for the delay in payment.

The manner of discharge of the functions of these PhilHealth officials, according to the mayor, has “caused undue injury to the hospitals and laboratory through manifest partiality, evident bad faith or gross inexcusable negligence violates Section 3 of Republic Act No. 3019 or the corrupt practice of public officers.”

“….the more important is the urgent need of PhilHealth to settle and release the payment claims of our hospitals and the Uswag Molecular Laboratory, which provide treatment, intervention, and detection for COVID-19 both private and public; and therefore, this is an urgent appeal for the immediate and unhindered release of the payment claims already filed,” the complaint letter read.

The letter was addressed to Deputy Ombudsman Paul Elmer Clemente of Ombudsman Visayas and Secretary Jeremia B. Belgica, director general of Anti-Red Tape Authority.

Treñas noted that this matter was already elevated to PhilHealth President and chief Executive Officer Atty. Dante A. Gierran “however, up to this day, our pleas have fallen to deaf ears.”

He emphasized that the claims have been filed and made with Philhealth in a timely manner, in accordance with existing policies at the time of its filing.

“However, to make the situation worse, it is as if Philhealth is making its rules for the release of lawful, valid, and ripe claims, as it goes along. Suffice to say, the method or procedure today, may be different tomorrow—which results in the denial of the claims which is evaluated, entertained and released at the time it was filed, would have been released,” it added.

Treñas feared that the non-release of the said claims would result in failure of the medical institutions to effectively meet medical needs.

“As Mayor of the city of Iloilo, it is my responsibility to insure the welfare of my constituents by taking the lead maintaining health services and because of this COVID-19 pandemic it is very important to address the deficiency of these PhilHealth officials that has resulted to the failure our medical institutions to effectively meeting urgent and long term medical needs leading to loss of life at times due to shortage of funds,” he stressed.

Hollero, on the other hand, said he was saddened that Treñas has resorted to filing a complaint against them.

“I feel bad for the 402 hard working employees of PhilHealth Regional Office VI who have worked so hard to process good claims immediately in order to help our partner hospitals at this time of pandemic,” she said in a statement.

“As shown during the congressional hearing on Philhealth’s Unpaid Hospital Claims this afternoon (Sept. 3), Philhealth-6 has a turn around time of 27 days and has the highest number of claims processed per employee nationwide at 1,255 a month,” Hollero further said.IMT/Photo by Arnold Almacen/CMO