Tuesday Feb, 18 2020 09:26:40 PM

PhilHealth holds suspension of accreditation of GenSan hospital

HEALTH • 10:30 AM Sat Oct 26, 2019
Hanah G. Naanep/PhilHealth 12 information office
PhilHealth 12 officials hold news conference in Koronadal City.

KORONADAL CITY - Effective October 21, 2019, the General Santos Doctors Hospital, Inc. (GSDH) suspension of accreditation order shall be held in abeyance as directed by the PhilHealth Arbitration Office, PhilHealth Region 12 said in a statement.

Members and their qualified dependents may now continue availing of their PhilHealth benefits from GSDH.

The same hospital may continue filing benefit claims in terms of services they have provided to the members and PhilHealth Region XII may receive, process and pay all of their filed claims.

Dr. Antoniette M. Ladio, PhilHeath 12 Acting Regional Vice President made it clear during the press conference held earlier last week that accreditation is a privilege. Not all hospitals are accorded the same.

“Only those who pass PhilHealth’s standard and those who abide by the implementing rules and regulations qualify. Suspension and withdrawal of accreditation only happen when there are violations,” he said.

Suspension of accreditation and fines are administrative penalties enforced for cases involving fraudulent and non-fraudulent acts under the Revised Implementing Rules and Regulations of the National Health Insurance Act of 2013, as amended.

Withdrawal of PhilHealth accreditation is imposed when a health care institution is non-compliant with the guidelines, standards and procedures per evaluation of its capabilities and integrity.

The previous pronouncement on the suspension of the Gen. Santos Doctors Hospital was due to the padding of claims, claims for non-admitted patients, misrepresentation and breach of performance commitment.

The withdrawal of PhilHealth accreditation of Dr. Arturo P. Pingoy Medical Center and Allah Valley Medical Specialits Center, Inc. on the other hand, as recommended by the Legal Services Sector Central Office was due to the suspicion that they are doing fraudulent activities.

With the dialogue on the group of patients undergoing dialysis treatment, PhilHealth explained that it is the duty of the corporation to protect its fund and execute penalty to those who have committed violations.

Members’ sentiments were transcribed and forwarded to the Health Finance Policy Sector for appropriate action.

The Regional Office Management Committee did its thorough deliberation on feedbacks and all other issues and concerns received from clients.

The same committee has provided recommendations to the Central Office for favorable action and consideration.

No word yet from PhilHealth central office on the cases of Dr. A Pingoy and Allah Valley hospitals in Koronadal City. (Hanah G. Naanep, PRO III)

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