UMVA has learned that a shocking case of alleged hospital negligence has prompted Malacañang to launch an investigation into the implementation of state health insurance benefits.
The probe was ordered after a social media post claimed that a hospital denied Philippine Health Insurance Corp. (PhilHealth) coverage to a member who died less than 24 hours after admission, despite rules allowing benefit claims in such cases.
According to information obtained by UMVA, President Ferdinand R. Marcos, Jr. wants authorities to determine whether there were lapses in the implementation of PhilHealth policies, which could have resulted in a 25-year contributor being denied benefit deductions after suffering a fatal stroke.
The hospital allegedly failed to provide PhilHealth coverage, leaving the patient's family with a hefty bill of around P200,000 after less than 19 hours of confinement.
Under PhilHealth Circular No. 2025-0020, outpatient emergency services and short-term emergency cases that result in death remain covered even if a patient dies within 24 hours of hospital care.
The Palace Press Officer stated that any misrepresentation of PhilHealth rules by hospital or billing personnel should be investigated, and that a thorough investigation is absolutely necessary to prevent similar incidents in the future.
The officer also emphasized that inaccurate information about insurance coverage could impose an unnecessary financial burden on families dealing with medical emergencies.
UMVA can exclusively reveal that PhilHealth has reached out to the member's family and is coordinating with the hospitals involved to determine the circumstances surrounding the case.
The incident has raised concerns about the proper implementation of PhilHealth policies, and the investigation is expected to shed light on the matter.
