IC wants to regulate mall-based health clinics

The Insurance Commission (IC) is looking at mall-based health clinics as another sector that must be regulated.

Mall-based clinics are providers of primary and multispecialty health care. It offers minor surgical operations, special medical examinations and preventive healthcare, and specialized medical consultations. These services are performed by doctors and other medical specialists.

However, it is not regulated by any specific government agency such as the Department of Health (DOH) or the Department of Finance (DOF).

IC commissioner Emmanuel Dooc said that in the course of setting the regulatory framework for the health maintenance organization ( HMO) sector, the issue of the growing mall-based clinics arises.

“We will also look into the mall-based clinics, and others that are not classified as HMOs,” Dooc said, adding these clinics show a lot of similarity with the HMO operations.

Like HMOs, it requires a certain membership fee from interested individual and in turn renders health and wellness services outside of the hospital.

“To a certain extent, they are taking over the business of HMOs,” the regulator said.

Meanwhile, the HMO industry has until April 28 to respond and finalize the regulatory framework proposed by the IC.

“Government wants the framework to be in place so we can revive the industry and offer affordable medical services to the public,” Dooc said.

The Association of Health Maintenance Organizations of the Philippine Inc. (AHMOPI) said that the proposed regulations are still being circulated to its members for comments and suggestions.

“We have given all our members up to April 15 to submit comments,” AHMOPI executive director Carlos D. Da Silva said.

AHMOPI is the only HMO trade organization in the country which groups Medicard Philippines, Intellicare, Insular Health Care, Health Plan Philippines, Health Maintenance, Cocolife Healthcare, Caritas Health Shield, Blue Cross Health Care, and Avega Managed Care.

The DOH reported there are 23 SEC-registered HMOs while the IC 20 players.

The IC proposal requires a minimum paid- up capital requirement of P10- million for existing players and P100 million for new entrants. When the HMO industry was under the regulatory guidance of the health department, it was required to only report a P10,000 capital.

HMO must deposit with a trustee bank in a custodial account, the value of P2 million or 20-percent of HMO’s paid up capital either in cash, Treasury bills, Treasury bonds, or any combination.

“The deposits will be used to protect the interest of the HMO members (or covered persons) and to assure continuation of health care services to covered persons of HMOs,” the IC said.

initially reports