PhilHealth: Increase of Dialysis Coverage From 45 to 90 Days is in Response to Clamor of Members and Lawmakers

The Philippine Health Insurance Corporation (PhilHealth) said on Friday the increase on the maximum number of dialysis coverage from 45 days to 90 days per year was in response to clamor from both the PhilHealth members and lawmakers.

“This is in response to the call of our members for us to increase the number of dialysis treatment, and also with the initiative of both supportive members of both the Senate and the House of Representatives,” PhilHealth President and CEO Atty. Alexander Padilla said.

In the quarterly “Kapihan with the CEO” held at the PhilHealth main office in City State Centre at Shaw Blvd., Pasig City, Padilla said the new development in PhilHealth’s dialysis package was specified under PhilHealth Circular No. 022, Series of 2015.

“Under that Circular No. 022, claims for admission/dialysis sessions started on July 28, 2015,” the PhilHealth president and CEO added.

As an example, he cited that if a patient had undergone 40 dialysis in the month of July and the remaining days was just five days, an additional 50 days will be added for the availment of dialysis treatment.

The new package rate, both for peritoneal and hemodialysis cases, was reduced to PhP2,600 from the previous PhP4,000. The rate covers services rendered in the facilities and professional fees of physicians.

The PhilHealth Board of Directors approved the expansion to help ease the financial burden of members and their dependents, given the growing incidence of kidney diseases in the country.

According to Padilla, the increase is timely and reasonable, citing that waiting for legislation or law to be passed both in the Senate and the House can cause delay and may deprive the PhilHealth patient members needing an increase in the number of dialysis treatment days of the chance to enjoy the health services they deserve.

He said that while there is a pending measure in the House of Representatives, the absence of the counterpart in the Senate is a big stumbling block.

Padilla noted that the forthcoming election campaign, for example, may hamper the passage of the law and slow down the package of benefits needed to be delivered.

Moreover, he also said that if there will be a legislation or law that will be passed, there is a tendency that some difficulties may arise in the future because there are rules that will require to be amended and amendments sometimes entail time and also costs.

He added that in case a law concerning dialysis package will be passed, the tendency to do the same in all other case rate packages of PhilHealth will also be required.

He said he is thankful to the lawmakers who understood and presented to them the idea of the formulation of package rates which they continue to introduce in order to fit with the growing need of the PhilHealth members as part of the effort to fulfill the goal of Universal Health Care Agenda of the government. (PNA) SCS/LSJ