BACOLOD City – The Negros Healthcare Management Services, Inc. (NHMSI) filed a motion for reconsideration (MR) before the Philippine Health Insurance Corp. (PhilHealth) to appeal the latter’s denial of accreditation to the Bacolod Our Lady of Mercy Specialty Hospital.
NHMSI’s legal counsel Atty. Rafael Ocampo passed the MR to his PhilHealth counterpart Atty. Dennis Guevara at the Office of the City Mayor on Monday.
The NHMSI manages the “hospital for the poor,” which faced closure on June 19 following the denial of its accreditation as a Level 2 health care provider.
Last Friday, Mayor Evelio Leonardia called the hospital management and PhilHealth representatives for a meeting at the Bacolod City Government Center.
The meeting, which lasted for almost three hours, resulted to both parties agreeing with an “amicable settlement,” which postponed the hospital’s abrupt closure until July 30.
WHAT DID THE MR SAY?
Ocampo said the PhilHealth must take second look at its decision denying the hospital’s accreditation.
PhilHealth regional head Lourdes Diocson in a letter said the denial was due to the hospital’s “conviction of fraudulent acts” in violation of the National Health Insurance Act of 2013.
The hospital was found guilty of fabricated claims for cataract surgeries in 2006, the PhilHealth added.
Ocampo said this was a “grave error,” citing that there was no evidence presented that the hospital was indeed convicted of fraudulent acts.
The MR also requested PhilHealth to reaccredit the hospital and release claims for the months of March, April, May, and June this year.
MISTAKE OF THE PAST
Guevara said the hospital committed the “fraudulent acts” under its previous management – the Tiong Bi, Inc.
NHMSI only took over the hospital in 2014.
But even if this is the case, Guevara said the NHMSI must shoulder the burden, citing provisions of Republic Act 7875, or the National Health Insurance Act of 1995./PN