By PR | 01:46 PM June 01, 2021
The Philippine Health Insurance Corporation (PhilHealth) imposes a three-month suspension of the accreditation of Borja Family Hospital located in Tagbilaran City, Bohol.
Borja Family Hospital is “adjudged guilty and liable of administrative offense of extending period of confinement under Section 142, Rule XXVIII of the 2001 IRR of Republic Act No. 7875 in relation to PhilHealth Circular No. 14, s.2010 (Order Of Discharge), and is accordingly meted the penalty of suspension of three (3) months of its accreditation,” with a fine of Php 10,000.
PhilHealth filed a case against the hospital in 2014 after its Regional Legal Office found out, through a hospital inspection, that there was inconsistency in the claim filed by Borja Family Hospital for a patient’s confinement dated February 8 to 24, 2011. It was noted by the investigating team that the date of discharge indicated in the claim form is incongruous with the “May Go Home” order on the Physician’s Order Sheet which was dated February 21, 2011. The inconsistency was in violation of Circular No. 14, s.2010.
Borja Family Hospital filed appeals to the PhilHealth Board but were denied by the governing body; and petition for review and motion for reconsideration at the Court of Appeals which were all subsequently denied in 2016 and 2017. It further filed its petition with the Supreme Court, but the highest court resolves to deny the petition.
The three-month suspension of the accreditation of the hospital takes effect today, June 1, 2021 until August 29, 2021.
During this period, PhilHealth will not receive, process, nor pay any claims from Borja Family Hospital.
Members are advised to seek medical services in other health care institutions in the area.
