Manila: The Philippine Health Insurance Corporation (PhilHealth) on Tuesday announced the strategic phased rollout of its PhilHealth Guaranteed and Accessible Medications for Outpatient Treatment (GAMOT) program. This initiative aims to ensure the timely payment of partner pharmacies and safeguard the system against potential fraud.
According to Philippines News Agency, the program was initially launched in select partner pharmacies across the country. PhilHealth GAMOT is designed to expand access to essential medicines for its members. Although the expanded rollout is still underway, PhilHealth has assured the public that 21 essential medicines continue to be available through the Yaman ng Kalusugan Program or YAKAP clinics.
PhilHealth’s acting President and Chief Executive Officer, Edwin Mercado, emphasized that the phased approach is intended to balance accessibility with accountability. He stated, “Mabilis, patas, mapagkakatiwalaan, ‘yan ang ating gabay. Mabilis man ang hangad natin, kaiba ito sa minadali (Fast, fair, and trustworthy, that is our guide. While we aim for speed, this is different from being rushed).”
To address concerns from pharmacies regarding reimbursement delays, PhilHealth has committed to a 15-day payment cycle for valid GAMOT claims. The organization has also deployed dedicated support staff to streamline claims processing, with checks for approved claims being issued ahead of the 15-day target.
In a bid to ensure program integrity, PhilHealth is developing a comprehensive fraud prevention system. This includes integrating the Philippine Identification System Registry and exploring artificial intelligence-powered monitoring tools.
Through the phased implementation, PhilHealth aims to strengthen public confidence in its capacity to deliver benefits in a timely and responsible manner. Pharmacies interested in joining the program are encouraged to reach out to PhilHealth’s regional offices for inquiries.