The Benefits Committee (BenCom) of the Philippine Health Insurance Corporation (PhilHealth) Board of Directors (Board), chaired by Health Secretary Ted Herbosa, endorsed to the Board en banc better benefit packages for heart attacks, ten rare diseases, preventive oral health at primary care, peritoneal dialysis, and assistive mobility devices.
“To lower the health expenses of Filipino families, radical change must happen from within PhilHealth,” Herbosa stressed.
“It has to do better – settling all arrears, paying reimbursement claims faster, and increasing cost coverage.”
“It has to do better – settling all arrears, paying reimbursement claims faster, and increasing cost coverage. Today’s BenCom endorsement is one of many that the DOH has been leading in that regard,” the health chief added.
There are eight major steps needed to implement a new PhilHealth benefit or to enhance an existing one:
1) benefit development;
2) policy development;
3) policy approval;
4) IT system development;
5) publication;
6) IT system enhancement;
7) user training/orientation; and
8) effectiveness assessment.
Board action is found in only two of these eight: policy development and policy approval.
The six other steps are within Management and the President and CEO’s direct control.
“The job of PhilHealth is to pay the health benefits of its members.”
“The job of PhilHealth is to pay the health benefits of its members. It is President Ferdinand R. Marcos Jr.’s standing instruction for the DOH to steer PhilHealth along these lines through its Board,” the health head stressed.
The better benefits endorsed for Board approval include a package for acute myocardial infarction (AMI) or heart attacks across the continuum of care; ten rare diseases that include Maple Syrup Urine Disease, Methylmalonic Acidemia/Propionic Acidemia, Galactosemia, Phenylketonuria, Gaucher Disease, Pompe Disease, Fabry Disease, MPS II (Hunter Syndrome), MPS IV (Morquio Syndrome), and Osteogenesis Imperfecta; preventive oral health services to complement the PhilHealth Konsulta package; improved coverage for Peritoneal Dialysis; and assistive mobility devices for priority conditions that affect the most in need for physical rehabilitation.
The Board en banc will have its next regular meeting before the end of the month.
