An Akbayan party-list lawmaker is pushing for the establishment of Philippine Health Insurance Corporation (PhilHealth) member assistance desks inside hospitals, along with a review of its 24-hour confinement policy, citing concerns over delayed or denied benefits for paying members.
Rep. Dadah Kiram Ismula said the proposed hospital-based help desks would allow patients and families to immediately raise and resolve issues related to benefit claims without needing to escalate concerns outside medical facilities.
The call follows reports of a recent case that went viral involving a PhilHealth member whose family was reportedly unable to access benefits after the patient’s death due to the implementation of the 24-hour confinement rule.
“Hindi puwedeng maging requirement sa pasyente ang mag-viral bago mabigyan ng aksyon ng PhilHealth,” Ismula said.
She stressed that members who consistently pay contributions are entitled to prompt and accessible services, especially during medical emergencies when delays can have serious consequences.
“Sa loob pa lamang ng ospital, dapat ay may direktang masasandigan ang ating mga kababayan sa oras ng kanilang pangangailangan,” she added.
Ismula also urged a policy review of the 24-hour confinement rule, which limits full coverage for patients discharged or who die within 24 hours of admission, noting that safeguards against fraud should not disadvantage legitimate members.
“We seriously urge PhilHealth to investigate and study the 24-hour confinement rule because in fighting against fraud, the paying members should not be at the expense of the system,” she said.
She added that existing safeguards should be reassessed to ensure that efficiency measures do not unintentionally restrict access to benefits during urgent medical situations.