PhilHealth recalls suspension order vs GenSan hospital

GENERAL SANTOS CITY (MindaNews / 22 Oct) – The Philippine Health Insurance Corp. (PhilHealth) has temporarily recalled the suspension order it issued early this month over the accreditation of a hospital here that it had found involved in “fraudulent activities.”

In a public advisory issued on Monday afternoon, PhilHealth-Region 12 said it is “holding in abeyance” the implementation of General Santos Doctors Hospital Inc.’s (GSDHI) suspension, which was supposed to take effect on the same day.

It did not cite the reasons for such decision, which was based on an order dated Oct. 17 issued by PhilHealth central office’s arbitration office.

The order was for case numbers HCP-XII-08-007 and HCP-XII-08-014, all involving GSDHI, that was covered by a writ of execution issued last Aug. 21.

“As a result thereof, claims for benefits during confinements or for services rendered in the said health care institution shall be received, processed and paid by PhilHealth,” said the advisory signed by Dr. Antoniette Ladio, acting regional vice president of PhilHealth-12.

PhilHealth-12 initially released an advisory last Oct. 10 announcing the suspension of GSDHI and the withdrawal of the accreditation of Dr. Arturo P. Pingoy Medical Center (DAPPMC) and the Allah Valley Medical Specialists Center Inc. (AVMSCI), both based in Koronadal City, for allegedly being “involved in the commission of fraudulent activities.”

The suspension of GSDHI was ordered from October 21, 2019 to January 18 2020 and from Jan. 19, 2020 to April 17, 2020 or a total of six months.

PhilHealth-12 said the hospital violated “pertinent provisions of Republic Act 7875 or the amended National Health Insurance Act of 2013.”

Citing a report from its legal division, PhilHealth-12 public information officer Hanah Naanep said the violations committed by GSDHI are “padding of claims, claim for non-admitted patients, misrepresentation and breach of performance commitment.”

In a press conference in Koronadal City last Oct. 14, Ladio said they served the writ of execution for the hospital’s suspension as its cases were already decided with finality by the Supreme Court.

He said GSDHI may apply for “re-accreditation” with PhilHealth once it serves the six-month suspension.

As to the cases of DAPPMC and AVMSCI, Naanep said their central office has yet to decide on the appeals they filed regarding the withdrawal of their accreditation, which took effect last Oct. 10.

“We’re still waiting for the decision on their motions for reconsideration,” she said.

PhilHealth-12 has repeatedly refused to disclose the violations committed by DAPPMC and AVMSCI but said the withdrawal was a “preventive penalty” against them. (MindaNews)