Is the government paying more than it should?

This definition of “overpayment” in the context of FFS is outright wrong. We are accustomed to thinking that paying a peso for every peso is the only right thing to do in a country that is deluged by cases of graft and corruption. Our past has conditioned us to think that paying over or under the bill is either corruption or injustice.

In FFS, overpayment does not actually mean paying over the amount printed in the bill. It pertains to paying HCPs for services that are likely beyond the usual/average. In case-based payment, the *average* services have been pre-determined and average costs have been set prospectively. By doing this, hospitals will know that the government will only pay for the specified case rates. 


On the contrary, these services and rates have not been prospectively determined under the FFS scheme. PhilHealth paid a peso for every peso even though these services should not have been given to a patient; thus, the “overpayment”.

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