Another data leak hits PhilHealth

Another data leak hits PhilHealth

MANILA, Philippines — Bugs or coding errors, not cyber hackers, caused glitches that hit the Philippine Health Insurance Corp. (PhilHealth)’s website over the weekend, Department of Information and Communications Technology (DICT) Undersecretary for cybersecurity, connectivity and upskilling Jeffrey Ian Dy said yesterday.

The bug, however, has been fixed, according to Dy, as he gave assurance that the PhilHealth website is back to normal.

“It seems that there were some errors made in building the website. They fixed it already. It was a bug,” he told The STAR.

The PhilHealth website had suffered a Medusa ransomware attack perpetrated by cyber hackers in September last year, where the hackers tried to extort $300,000 from PhilHealth.

A Medusa ransomware is a type of malware that encrypts files and demands a ransom payment for the decryption key.

DICT Secretary Ivan John Uy had previously said a report done on the cyber attack showed that the Medusa ransomware attackers had stolen some 600 gigabytes of data from the PhilHealth website.

The National Privacy Commission (NPC) has also taken steps to look into the incident.

“We already informed the quick response team and they will conduct an initial investigation,” NPC public relations officer Kate Lo told The STAR.

Agency assistance

Following the development, PhilHealth advised its members who are having problems accessing the member portal to immediately seek assistance from the agency.

Rey Baleña, acting vice president of PhilHealth’s corporate affairs group, said they are ready to help these members having problems in gaining access to PhilHealth’s member data record.

“We can directly assist these members and help check the issue. We will just need their details to be able to help them,” Baleña said in a Viber message.

“Upon checking, the systems are up and running. We don’t have any advisory about issues in our member portal,” he added.

Baleña likewise disclosed that PhilHealth is in constant coordination with the DICT, especially in the former’s digital transformation program.

At a briefing last Friday, PhilHealth assured the public that the hacking incident that affected PhilHealth’s systems last year would not be repeated.

“We learned our lesson. That’s the silver lining in all of these. We’ve strengthened our systems. I think it’s safe to assume that probably, it will not happen again,” PhilHealth president and chief executive officer Emmanuel Ledesma said.

Unpaid claims

Meanwhile, the Private Hospitals Association of the Philippines Inc. (PHAPI) is appealing to PhilHealth to settle its unpaid claims amounting to more than P6 billion.

“Previous receivables” of private health facilities remain in the form of denied, in process and return-to-hospital (RTH) claims, according to PHAPI.

“Since the patients come and go, the current accounts are in the process of being paid. However, a lot of hospitals are still asking them to pay the P6 billion-plus that included denied, in process and ‘return-to-hospital claims,’” PHAPI president Dr. Jose Rene de Grano said in an interview yesterday.

“The hospitals are continuously refiling the claims. We have asked them regarding the reasons for the denial of claims, and if they cannot provide the reasons, then they should pay the claims. For several years they have not acted on those claims,” he added.

The total amount of unpaid claims is more than P10 billion, including what PhilHealth owes government hospitals, according to the PHAPI chief.

De Grano said this is 10 percent of total hospital claims amounting to over P100 billion, as what the state health insurer presented during its recent meeting with PHAPI.

As to the RTH, he explained that this usually could be paid at once as soon as compliance is made.

“Usually, the deficiency is institutional – no signature, no diagnosis and some documents are missing,” De Grano said.

As to denied claims, he noted that a lot of them are due to “non compliance to standard of care” which, for hospitals, is a vague reason since the standard of care compliance may be subjective as assessed by the evaluator.

“They are questioning the credentials of the evaluators since most of them are desk physicians and not specialists like the doctors who are attending to patients,” the PHAPI leader said.

De Grano added that most of the denied claims are sent to the Protest and Appeals Review Department at PhilHealth’s main office.

“It takes months and years for it to be decided on. They are even saying that they do not have enough manpower in the said department,” he said.

At a press briefing last Friday, PhilHealth said it has already paid a total of P46.5 billion out of the more than P100 billion to both public and private hospitals.

A total of P26.2 billion has been paid to private hospitals, and P20.3 billion to government hospitals.

Increased benefits

For AGRI party-list Rep. Wilbert Lee, the benefits of PhilHealth should increase if the hike in the state insurer’s premium rates will push through.

Lee said PhilHealth should increase its health packages by 30 percent across the board if it will implement the five-percent hike in premium.

“It is saddening and disappointing that they will increase the premium of PhilHealth while they have been ignoring our calls for the 30-percent increase in benefit packages and coverage,” he added.

Lee noted that the current benefit packages of PhilHealth are not enough to sufficiently address the health needs of its members and beneficiaries.

The lawmaker made the statement as PhilHealth is poised to increase its premium rate from the current four percent to five percent.

When this adjustment happens, the state insurer is expected to collect some P17 billion in additional revenues.

Lee said he wrote a letter addressed to Ledesma in October last year to formally request the adjustment in benefits.

In House Resolution No. 1407 that Lee authored, it was underscored that PhilHealth’s case rates are no longer responsive to the hospitalization cost of the beneficiaries.

The resolution proposes that there should be no limit in its covered dialysis sessions, chemotherapy, heart bypass surgery and other diagnostic tests and preventive measures to ease the burden of patients and their families.

“It is inevitable that our countrymen worry about getting sick because of the high costs of quality medical care. The rich will go bankrupt when they get sick. How much more the poor?” Lee said.

Meanwhile, Gabriela Women’s party-list Rep. Arlene Brosas yesterday asked the Marcos administration to suspend the impending increase in PhilHealth premium.

Citing the unabated price hikes affecting workers, Brosas said the adjustment would also “equate to higher income deductions for wage and salary workers who are struggling with nonstop price hikes of basic goods and services.”

“The increase in premium rates is particularly insensitive to Filipino workers who are struggling to make ends meet on meager wages. This is precisely why we filed House Bill 408, which seeks to amend the UHC (Universal Health Care) Law by repealing the provision for the automatic increase of premium contributions,” she added. — Rhodina Villanueva, Sheila Crisostomo