PhilHealth suspends AHC accreditation for 3 months

| Photo from PhiHealth Region VII FB page

MANDAUE CITY, Cebu –  The Philippine Health Insurance Corporation (PhilHealth) has ordered the suspension of accreditation of a private hospital located along Tres de Abrial Street in Cebu City for three months for “misinterpretation by furnishing false or incorrect information and breach of accreditation.”

The suspension of the accreditation of Adventist Hospital Cebu, Inc. (AHC), formerly known as the H.W Miller Memorial Sanitarium and Hospital, starts on Sunday, August 1, and will continue until October 29, 2021.

“Within these dates, PhilHealth will not receive, process, nor pay any claims from Adventist Hospital Cebu, Inc. Members are advised to seek medical services in other accredited health care institutions in the area,” the Central Visayas office of PhilHealth said in an advisory.

AHC management was also asked to pay a fine of P10, 000.

PhilHealth asked its members to avail of the services of other accredited health care institutions during the period.

As of this writing, CDN Digital is yet to get the side of the hospital’s management.  Calls made to landlines numbers that were listed on its official Facebook page were unanswered.

A copy of Philhealth’s suspension order was sent to their Central Visayas Office in May.  The same was also furnished to hospital management in June.

In an advisory, PhilHealth said that AHC was first meted with a suspension of its accreditation for six months and a fine of P20,000.

This was later on reduced to three months and a fine of P10,000 in 2013 after the hospital filed a Notice of Appeal and Memorandum of Appeal.

The case against AHC stemmed from the findings which PhiHealth-7’s Accreditation Section made after a review of the accreditation of then Miller Hospital in 2007.

PhilHealth-7 found out that SouthMed Dialysis Center, Inc. (SMDC), a dialysis clinic tenant,  filed dialysis claims using the Miller Hospital’s name.

“Although there was a contract of lease between both facilities, there was no memorandum of agreement stating SMDC as an outsourced service unit of Miller,” PhilHealth said.

In 2009, the Prosecution Department at PhilHealth’s head office filed a complaint for Misinterpretation by Furnishing False of Incorrect Information and a breach of the warranties of accreditation against the hospital.

Miller hospital reportedly filed a Motion to Dismiss in 2013 while AHC, which took over the hospital’s operations, assets, and liabilities, filed a Manifestation with Motion for Reconsideration in 2016.

However, both motions were denied by the PhilHealth Board.

In 2017, the Court of Appeals as well as the Supreme Court also denied the petition for review and the motion for reconsideration that AHC filed .

RELATED STORIES

NBI-7 files charges against PhilHealth-7, hospital officials for upcasing

Adventist Hospital – Cebu: We complied with PhilHealth guidelines

Philippine College of Physicians-CV: Upcasing charge vs AHC staff ‘disheartening’

 

Read more...