A lawmaker is calling on the Department of Health (DOH) to enforce transparency standards and establish concrete safeguards to prevent doctors from artificially inflating their professional fees under the government’s Medical Assistance to Indigent and Financially Incapacitated Patients (MAIFIP) program.
Parañaque Representative Brian Yamsuan issued the call following complaints raised by fellow legislators that certain medical practitioners substantially mark up their fees upon learning that the bill will be covered by the state assistance fund. The practice effectively inflates overall hospital bills for vulnerable patients rather than lowering out-of-pocket expenses.
“Kailangan natin tingnan ang transparency and accountability rin ng mga doctors. Kailangan mag-set up [ang DOH] ng mekanismo para to make sure na yung mga kababayan natin hindi malagay sa alanganin,” Yamsuan emphasized during the House Committee on Appropriations hearing on the health department’s proposed budget for 2027.
The MAIFIP, which is administered through public hospitals and facilitated alongside legislative offices, serves as a financial safety net for patients whose medical expenses exceed PhilHealth benefit limits or other existing funding options.
In response, Health Secretary Edwin Mercado outlined a three-pronged strategy currently being implemented by the agency to address the issue. First, the agency has accelerated PhilHealth reimbursement times for doctors’ fee payouts to 15 to 20 days. Speedier payments disincentivize practitioners from preemptively raising rates to hedge against long processing delays. Second, the DOH and PhilHealth have partnered to launch a “Single Source of Truth” database to track and verify that doctors apply consistent billing rates across public and private cases. Third, the department has begun consultations with major medical specialty groups, including the Philippine College of Surgeons, to establish standardized fee benchmarks alongside incentives for specialists serving in rural and remote regions.
Yamsuan welcomed the measures and reaffirmed that Congress stands ready to provide the DOH with the necessary funding and legislative backing. He noted that institutionalizing these controls will safeguard public funds while ensuring complimentary initiatives, such as the No Balance Billing policy and free essential medicines programs, reach indigent patients without friction.