Cagayan de Oro Representative Rufus Rodriguez has called for a congressional inquiry into the Philippine Health Insurance Corporation’s (PhilHealth) P59.6 billion worth of unpaid hospital claims, citing its severe impact on healthcare services and workers.
In House Resolution No. 2173, Rodriguez stressed that the delayed payments have forced some hospitals to partially or fully shut down services, leading to job losses and depriving PhilHealth members of critical medical care.
“This non-payment has resulted in terminations and closures, affecting hospitals and their ability to serve patients. It is crucial for the House to investigate this issue and find solutions to help hospitals comply with requirements for claims,” Rodriguez said in a GMA News report.
During a recent House hearing, lawmakers were informed that PhilHealth had denied 483,000 claims worth P4.7 billion in 2024 alone. Additionally, about three million claims amounting to P32.4 billion from 2018 to 2023 were rejected due to hospitals failing to meet the 60-day filing requirement.
Rodriguez highlighted that PhilHealth possesses sufficient financial resources to address these claims. He cited the insurer’s P759 billion in accessible funds, which include reserves, premium collections, investment income, and unreleased appropriations.
Despite these funds, hospitals and members continue to suffer from unpaid dues, he said.
PhilHealth recently announced expanded member benefits, including outpatient emergency services, shortly after President Ferdinand Marcos Jr. signed the 2025 national budget, which provided no subsidy to the state insurer due to its slow progress in improving member coverage over the years.
