Lung Center flagged for millions in unremitted benefits for patients

Lian Buan
Lung Center flagged for millions in unremitted benefits for patients
P22.6 million of the amount comes from Philhealth which should have been refunded to patients who are also members

MANILA, Philippines – State auditors flagged the Lung Center of the Philippines for more than P20 million in available funds which the hospital failed to remit to patient-members entitled to such benefits.

The Commission on Audit (COA) found the following in its annual report of the Lung Center:

  • P22.6 million in Philhealth funds which the hospital has not refunded to patient-members
  • P1.066-million worth of trust funds which remain idle and unremitted to patients

PhilHealth

The COA found that the Lung Center has managed to refund to patients only 19% of its available Philhealth funds.

“Of the total amount of P28.058 million received from the Philippine Health Insurance Corporation (PhilHealth) representing PhilHealth Medicare Patients Refunds for the period 2002 to 2018, only P5.442 million or 19% was actually refunded to concerned patient-members, leaving P22.616 million still to be refunded as of December 31, 2018,” said the Commission on Audit (COA) in its 2018 report of the Lung Center.

Auditors said this violates Philhealth rules and “deprives the concerned patient-members of their benefit.”

According to Philhealth Circular No, 2, all accredited health care providers who have already been reimbursed by the National Health Insurance Program (NHIP) should refund patients 60 days within receipt of the funds from Philhealth.

Auditors added that in the event of a failure to refund, even when the patients themselves fail to claim the refund, the money should go back to Philhealth, which the Lung Center also did not do.

The Lung Center told COA in their exit conference that a team is already assigned to look into the issue and ensure refunds.

Trust funds

The COA found another problem in the Lung Center’s trust funds, where there are P1.066-million worth of funds which have remained idle for two to 8 years already, again depriving patients of the program’s intended benefits.

“Review of the fund transfers from other government agencies recorded under Due to National Government Agencies (NGAs) and Trust Liabilities accounts showed that seven trust funds totalling P1.066 million remained idle/unutilized for more than two to eight years,” the COA said.

The amount in the trust fund came from the Department of Health (DOH) and the Philippine Sweepstakes and Charity Office (PCSO).

Of the amount, there is P400,000 from the DOH intended for the Philippine National Program for Elimination of Asbestos-related Diseases.

“The non-utilization defeated the purpose of the program and deprived the intended patients of the benefits that could have been derived therefrom,” said auditors. – Rappler.com

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Lian Buan

Lian Buan covers justice and corruption for Rappler. She is interested in decisions, pleadings, audits, contracts, and other documents that establish a trail. If you have leads, email lian.buan@rappler.com or tweet @lianbuan.