Senator Mark Villar calls for stronger member protection after PhilHealth controversy

Senator Mark Villar has called on the Philippine Health Insurance Corporation (PhilHealth) to strengthen its policies, improve accountability mechanisms, and enhance the delivery of benefits.

The senator emphasized the importance of ensuring that no Filipino is denied access to healthcare assistance during their times of greatest need.

Villar called for policy review following a viral case involving a widow’s claim for PhilHealth benefits. The family was reportedly denied coverage because the husband, a long-time member, did not meet the agency’s 24-hour confinement requirement.

This incident has sparked significant public concern and underscores the need to re-examine existing policies and their implementation.

“May Universal Health Care Law na tayo. Ang direksyon ng ating healthcare system ay dapat nakatuon sa mas malawak na access at mas mabilis na serbisyo, hindi sa mga patakarang nagdudulot ng kalituhan at pangamba sa mga miyembro. Walang pamilyang dapat mabigla na hindi nila magagamit ang benepisyong matagal nilang pinaghirapan dahil lamang sa teknikalidad,” Villar said.

Senator Villar has called on PhilHealth to conduct a comprehensive review of its claims processing system.

The key recommendations include evaluating the removal of the 24-hour confinement requirement and launching stronger information campaigns to better inform members of their entitlements and procedures.

According to Villar, these reforms are essential to reduce confusion, accelerate processing times, and ensure the Universal Health Care Law is implemented through a more efficient, member-focused system.

“Bawat kontribusyong ibinabayad sa PhilHealth ay pinaghirapan ng ating mga kababayan. Nararapat lamang na magkaroon sila ng kumpiyansa na may institusyong handang umalalay sa kanila sa oras ng pangangailangang medical. Ang layunin ng PhilHealth ay protektahan ang mga Pilipino, at ito ay dapat na nakikita hindi lamang sa mga polisiya kundi sa aktwal na karanasan ng bawat miyembro,” Villar said.

Meanwhile, PhilHealth Senior Vice President Israel Pargas addressed the case where the deceased member received no benefits due to being hospitalized for less than 24 hours.

According to Mr. Pargas, while the 24-hour rule exists, there are other benefit packages available for members who pass away in a hospital less than 24 hours after being admitted.

In an interview over radio DZMM, Pargas said, "Siguro hindi lamang gaano napansin o nakita o hindi ganoon na-familiarize ang mga ospital o ang ospital kung kaya hindi nila nabigyan ng benepisyo."

-Paraluman News