Go seeks tougher HMO regulation

Senator Christopher “Bong” Go has pushed for the tougher regulation of medical insurance providers to boost competition among them and to provide Filipinos a more responsive healthcare system.

Go sought to amend Presidential Decree 1469, otherwise known as the Insurance Code of 1978, to institutionalize regulations governing health maintenance organizations (HMO).

In filing Senate Bill 2133 containing his proposed revisions, Go said that “as the insurance markets become more competitive, we have to be pro-active, revisit our policies and ensure that the necessary safeguards are in place to protect public interest.”

Under Executive Order (EO) 192 s. 2015, the Insurance Commission (IC) was granted jurisdiction over HMO, but ambiguities have remained over whether the provisions of the Insurance Code also apply to medical insurers.

To correct this, Go proposes including HMO into the law’s coverage which shall enable the IC to provide stricter supervision and better protect the industry and the insuring public from unscrupulous practices.

In a move meant to enhance industry competition, HMO will be subjected to the provisions of the Code not explicitly provided for in EO 192, according to

Go’s proposed amendment.

These provisions include the Commission’s powers to issue cease-and-desist orders to prevent fraud or injury to the public.

He pointed out that Covid-19 has underscored to many Filipinos the need to invest in healthcare, thus the HMO sector must be properly regulated to ensure the entry of more providers.

Amendments to Insurance Code aim to remove ambiguities on IC power over medical insurance providers.

Serving as chairperson of the Senate Committee on Health, Go noted that insurance, pre-need and HMO-regulated entities are making significant contributions to the country’s economy.

Life insurance, non-life insurance, and mutual benefit associations commanded an industry asset base of P1.72 trillion in the second quarter of 2019, an 11.79 percent increase from the P1.54 trillion recorded during the same period the previous year.

For HMO, industry assets grew from P32.91 billion in 2017 to P38.96 billion in 2018. At the same time, their total revenue grew by 15 percent from P39.32 billion to P45.30 billion.