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December 15, 2025 | 2:28pm
MANILA, Philippines — The Department of Health’s controversial aid program faced multiple implementation issues in 2024, including low fund utilization partly due to delayed releases and unliquidated transfers, the Commission on Audit (COA) reported.
Despite these problems, the bicameral conference committee approved a P51-billion budget for the program, up from the Senate’s P29 billion, even as critics and civil society groups raised concerns over its pork-like nature, given its reliance on guarantee letters from politicians.
Some lawmakers have opposed the increase to the Medical Assistance to Indigent and Financially Incapacitated Patients Program (MAIFIP), arguing it only fuels patronage politics instead of directly addressing Filipinos’ immediate healthcare needs.
The MAIFIP Program provides financial assistance to Filipinos who cannot afford to pay their hospital bills, covering medicines, consultations, laboratory tests, select surgeries, treatments, and post-hospitalization care, including professional fees. It is designed to ease out-of-pocket expenses for both inpatient and outpatient services.
The program’s allocation dropped to around P41.16 billion under the 2025 General Appropriations Act, down from P58.09 billion in 2024.
State auditors, however, flagged three major issues in the MAIFIP Program: delays in fund releases, slow disbursement and unaccounted transfers, and inconsistent application of the program’s rules and guidelines.
Idle funds, reimbursement delays, staffing gaps
In an audit report, published on December 2, COA identified massive underspending worth P3.013 billion in 2024.
In Western Visayas Center for Health Development, only P355.27 million of the P2.19-billion sub-allotment advice was used, leaving more than four-fifths of the operating unit's budget idle by the end of the year.
COA explained that the significantly late fund transfers left healthcare facilities in Western Visayas unable to spend their 2024 budgets in full, while additional funding for partner facilities was restricted due to underutilized 2023 funds.
At the same time, fund transfers were delayed at some health facilities that opted for reimbursement under the MAIFIP Program, as the release of funds required the complete submission of supporting documents.
The slow processing of reimbursements has also long been a concern for private hospitals in the country. Under MAIFIP guidelines, payments are supposed to be made within 60 days of filing a claim, but this timeline has often not been met.
This has pushed hospitals to withhold the processing of guarantee letters from government officials for indigent patients until they receive payment for MAIFIP-covered services.
Four other healthcare facilities were also affected by delayed fund releases, which state auditors found were only made in the last quarter of 2024. The utilization of funds was also further hampered by incomplete documentation and staffing shortages.
According to the report, "obligations and SAAs for MAIFIP were only incurred in November and December," which prevented the Central Visayas Center for Health Development from requesting the corresponding notices of cash allocation on time.
Mimaropa CHD left P982.54 million, or 38.14% of its budget, unspent in 2024. Eastern Visayas Medical Center still had P183 million, or 49.07%, unused, while Western Visayas Sanitarium and General Hospital reported an unobligated balance of P11.73 million (19.16%). Meanwhile, the Treatment and Rehabilitation Center in Dulag had P5.66 million, or 35.6%, remaining at the end of the year despite its smaller budget.
Other healthcare facilities were also flagged for deficiencies, including missing liquidation reports as of Dec. 31, 2024, and advisories inconsistent with MAIFIP guidelines, leaving an estimated P305 million unspent.
"The foregoing deficiencies pose risks to the proper implementation of the funds and cast doubt on the attainment of the objectives of the DOH's MAIFIP Program, which aims to improve service delivery and ensure accessible and efficient provision of medical and financial assistance," the COA report read.
State auditors urged the DOH and relevant healthcare facilities to expedite fund releases to CHDs and operating units, boost staffing and logistics, enforce fund liquidation and fully comply with MAIFIP guidelines.
While the bicameral conference committee agreed to increase MAIFIP’s budget to P51 billion, citing the promised zero-balance billing program and 1.1 million patients likely to be affected, the allocation still needs signing and ratification before it is officially approved by Congress.
