THE Philippine Health Insurance Corporation (PhilHealth) reported on Wednesday, March 8, 2023, its plans in response to the order of President Ferdinand “Bongbong” Marcos Jr. to expand its coverage for its members.

In a meeting at the Malacañang, PhilHealth officials led by its acting president and chief executive officer Emmanuel Ledesma Jr. said their short-term plan, which is being implemented from January to June 2023, includes increasing the hemodialysis coverage from 90 to 156 sessions, repealing the pay-whichever-is-lower corporate policy in payment claims and increasing the case rate of the top four packages covering 25 percent of filed claims.

Ledesma said PhilHealth will also increase its dialysis support to three times a week for outpatients, equivalent to full weekly coverage annually.

The agency will also introduce the PhilHealth mobile app and short message service (SMS) confirmations, as well as implementation of new benefit packages including the outpatient mental health benefit package, outpatient package for severe acute malnutrition for children below five years old and strengthen its Konsulta package.

It is also looking into rationalizing the Covid-19 in-patient packages, reverse transcription polymerase chain reaction (RT-PCR) and rapid antigen tests, as well as isolation packages.

Ledesma also announced that under PhilHealth’s mid-term plan, which will be introduced in 2024, they will carry out general amnesty for employers and government agencies with missed premium payments. This will cover businesses, employers and individuals, especially small and medium enterprises that cannot afford to pay the three percent interest on missed premium payments.

He said they are also planning to impose penalties on erring doctors and hospitals instead of simply revoking their accreditation, amend the Universal Healthcare Law (UHC) and increase the case rates of top 10 packages with the highest claims filed.

Ledesma said there will also be internal reorganization to ensure proper manpower complement, especially for claims processing and frontline services.

The agency will also launch its anti-fraud system in 2024.

For its long-term plans, PhilHealth will be pursuing digitalization and the construction of PhilHealth-owned buildings and facilities. (SunStar Philippines)