Senate
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*22 NOV 23 PI SO
NINETEENTH CONGRESS OF THE ) 
REPUBLIC OF THE PHILIPPINES ) 
First Regular Session 
)
RECEIVED ET/
SEt
S.B.
Introduced by SENATOR IMEE R. MARCOS
AN ACT
EXPANDING THE PHILHEALTH OUTPATIENT COVERAGE ON DIALYSIS AND 
RENAL REPLACEMENT THERAPY, AND FOR OTHER PURPOSES
EXPLANATORY NOTE
Article II, Section 15 of the 1987 Constitution provides that "the State shall 
protect and promote the right to health of the people and instill health consciousness 
among them". Further, Article XIII, Section 11 of the Constitution provides that "the 
State shall adopt an integrated and comprehensive approach to health development 
which shall endeavor to make essential goods, health, and other social services 
available to all the people at affordable cost There shall be priority for the needs of the 
underprivileged sick, elderly, disabled, women, and children. The State shall endeavor 
to provide free medical care to paupers."
The 2019 Global Burden of Disease, Injuries, and Risk Factors Study has shown 
that chronic kidney disease is the 4th leading cause of death among the Filipinos. 
According to the National Kidney and Transplant Institute (NKTI), one Filipino develops 
chronic renal failure every hour or about 120 Filipinos per million population every year. 
Latest estimates show that around 2.3 million Filipinos have chronic kidney disease.
Most Filipinos, however, cannot afford the exorbitant cost of medical treatment 
for kidney disease. Renal transplantation, on the other hand, is limited due to the 
expense and shortage of donors.
Pursuant to its duty under Republic Act (RA) No. 11223, or the "Universal Health 
Care Act", and cognizant of the needs of its members, PhilHealth intends to increase 
the coverage of hemodialysis while balancing the available resources to fund this 
benefit. Thus, the PhilHealth Board of Directors, through PhilHealth Board Resolution


No. 2718 s. 2022, approved the payment of benefit claims for hemodialysis services up 
to a maximum of 144 sessions for 2022.
In line with the Universal Health Care Act", this bill seeks to further expand the 
PhilHealth coverage of dialysis patients to include expenses in all dialysis treatments as 
well as the expenses of donors for renal transplantation procedures.
For the abovementioned reasons, the passage of this bill is earnestly sought.
IMEE R. MARCOS


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of liif
*22 NOV 23 PI 50
NINETEENTH CONGRESS OF THE ) 
REPUBLIC OF THE PHILIPPINES ) 
First Regular Session 
)
RECEIVED
SENATE
S.B. No. 1 n33
Introduced by SENATOR IMEE R. MARCOS
AN ACT
EXPANDING THE PHILHEALTH OUTPATIENT COVERAGE ON DIALYSIS AND 
RENAL REPLACEMENT THERAPY, AND FOR OTHER PURPOSES
Be it enacted by the Senate and House of Representatives of the Philippines in Congress 
assembled:
CHAPTER I
GENERAL PROVISIONS
SECTION 1. Short Title. - This Act shall be known as the "Comprehensive 
Dialysis and Rena! Replacement Therapy Act."
SEC. 2. Declaration of Policy. - The State shall endeavor to make essential 
goods, health and other social services available to all the people at affordable cost, as 
well as to improve the delivery of health care services to the people and to ensure that 
hospital facilities are available, affordable and accessible to all.
It is a declared policy of the State to adopt an integrated and comprehensive 
approach to health development that will provide Comprehensive Renal Replacement 
Therapy (RRT) to improve the delivery of health care services to patients diagnosed 
with End Stage Renal Disease (ESRD), and to encourage them to have a kidney 
transplant, preferably within the first two (2) years of starting dialysis.
SEC. 3. Definition of Terms. - As used in this Act, the following terms are defined 
as follows:
a. Dialysis facility refers to a health facility that provides treatment for ESRD 
patients and disseminates information on the various forms of RRT such as 
kidney transplantation, peritoneal dialysis and hemodialysis;


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b. End Stage Rena! Disease or ESRD refers to the final stage of chronic kidney 
disease in which the kidneys no longer function well enough to meet the 
needs of daily life;
c. Hemodialysis or HD refers to a medical procedure to remove fluid and waste 
products from the blood and to correct electrolyte imbalances. This is 
accomplished using a synthetic membrane or dialyzer which is also referred 
to as an "artificial kidney":
d. Indigent patient refers to a patient who has no source of income or whose 
income is not sufficient for family subsistence as identified by the Department 
of Social Welfare and Development (DSWD) through the National Household 
Targeting System (NHTS) for Poverty Reduction, or those patients who are 
indigents but are not listed in the NHTS as assessed by the provincial social 
development officer, city social development officer, or municipal social 
development officer, as the case may be;
e. Kidney transplant or KT refers to a surgical procedure to place a kidney from 
a live or deceased donor into a person whose kidneys no longer function 
sufficiently to sustain the person's life;
f. 
No Balance Billing refers to the government policy of not charging the medical 
expenses incurred over and beyond the PhilHealth package rates to a 
PhilHealth member who has undergone medical treatment:
g. Peritoneal dialysis or PD refers to a treatment for kidney failure and a type of 
dialysis that uses the person's peritoneum (lining of abdominal cavity) as the 
membrane through which fluid and toxic substances are exchanged with 
blood;
h. PD First Policy refers to the policy where peritoneal dialysis, when feasible, is 
offered as the first dialysis modality to RRT patients;
i. 
Renai replacement therapy or RRT refers to therapy that partially replaces 
the functions of the normal kidney. This may be in the form of kidney 
transplantation, peritoneal dialysis and hemodialysis.
SEC. 4. Chronic Kidney Disease (CKD) Prevention and Health Promotion. - All 
national, provincial, and regional government hospitals with dialysis service facility, and 
stand-alone dialysis facilities should establish CKD prevention strategies and health 
promotion activities which include: advocacy activities targeting relatives of dialysis 
patients who are at high risk for developing CKD themselves, the provision of 
instructional materials and regular educational activities on the common symptoms of 
kidney disease such as its risk factors, healthy diet and lifestyle, common tests to


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diagnose kidney disease, the most common causes of kidney failure, and advisories on 
the appropriate protocols for the diagnostic evaluation of possible kidney disease.
Patients and their relatives should be informed about the availability of the proper 
medicines from government health centers such as those for diabetes and hypertension, 
and the importance of the regular intake of medicines and monitoring of kidney function 
through regular laboratory testing and regular clinic follow-up with a qualified physician. 
All activities pertaining to the aforementioned programs should be documented 
accordingly.
SEC. 5. Philippine Rena! Disease Registry. - As a requirement for the renewal 
of their respective DOH licenses to operate a dialysis center or transplant facility, private 
and public hospitals, dialysis centers for both HD and PD, and transplant facilities shall 
be mandated to report to the Philippine Renal Disease Registry of the DOH the incidence 
and prevalence of patients receiving peritoneal dialysis or hemodialysis treatment, as 
well as those who have received a kidney transplant. Registration of all dialysis patients 
in the PhilHealth dialysis database will be required prior to the availment of benefits for 
both peritoneal dialysis and hemodialysis.
SEC. 6. PhilHealth Benefit for Dialysis Treatment. - The PhilHealth shall cover 
all expenses for maintenance dialysis treatments, in accordance with the implementing 
rules and regulations of Republic Act (RA) No. 11223, or the "Universal Health Care 
Act." The professional fee of the attending physician and hospital charges shall be 
included in the PhilHealth benefits for dialysis treatment.
For purposes of providing optimal financial risk protection to the most vulnerable 
groups including the poorest of the poor, the "No Balance Billing Policy" of the 
government is hereby provided for indigents.
SEC. 7. Dialysis Facility. - A dialysis facility shall be compliant with the licensing 
requirements imposed under DOH Administrative Order No. 2012-0001 dated January 
26, 2012 for hemodialysis, and PhilHealth-Accreditation for peritoneal dialysis facilities. 
Hospitals without dialysis facilities shall first put up the necessary equipment and 
qualified Staff to perform peritoneal dialysis services. For hospitals with existing 
hemodialysis facilities, a peritoneal dialysis unit shall be established immediately so that 
this more cost-effective dialysis option can be made available to patients. Hospitals shall 
preferentially be provided with the necessary personnel, equipment and supplies as 
required by PhilHealth for accredited facilities.
SEC. 8. Training for Peritoneal and Hemodialysis Treatment and Services. - The 
DOH, National Kidney and Transplant Institute (NKTI) and the Philippine Society of 
Nephrology (PSN) shall provide training for medical personnel such as physicians to 
take charge of the hemodialysis and peritoneal dialysis centers, hemodialysis and 
peritoneal dialysis nurses, hemodialysis and peritoneal dialysis technicians, operating


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room nurses, transplant ward nurses, transplant coordinators, and non-medical 
barangay health workers to support home based peritoneal dialysis. The NKTI shall 
accredit the centers that can provide training for the above personnel and training 
should include hands-on workshops for dialysis.
SEC. 9. PhilHealth Benefit for Kidney Transplantation. - All expenses for kidney 
transplantation from living donors shall be shouldered by PhilHealth pursuant to RA No. 
11223. This shall include the cost of laboratory work-up for both recipient and donor 
candidate, hospitalization for the transplant operation including induction 
immunosuppression and maintenance oral immunosuppression, machine perfusion of 
procured organs, the cost for organ retrieval, all medications required during the 
hospital stay, as well as post discharge laboratories.
The cost for organ retrieval and machine perfusion will be established by the 
DOH-Philippine Organ Donation Program for all organ procurement organizations.
The PhilHealth shall also cover the evaluation and screening of the kidney donor 
and recipient up to the transplant procedure and post-transplantation procedures and 
remedies. This is inclusive of both pre- and post-kidney transplantation measures for 
the benefit of ESRD patients.
In order to support kidney transplantation as the best treatment option that 
provides the highest quality of life for ESRD patients and ensures the return of the 
patient to full rehabilitation, the PhilHealth and the Philippine Charity Sweepstakes 
Office (peso) shall provide support for all maintenance immunosuppression for the 
lifetime of the transplant patient, as long as the transplanted organ is functioning and 
the patient remains dialysis-independent.
All RRT facilities shall be required to engage in regular organ donation advocacy 
activities that will provide education for all Filipinos to carry the organ donor card. 
Facilities will likewise establish a potential deceased organ donor referral system that 
will identify all potential deceased organ donors to the Philippine Network for Organ 
Sharing.
SEC. 10. Rehabilitation Program. - The DOH, in coordination with the 
Department of Labor and Employment (DOLE), Technical Education and Skills 
Development Authority (TESDA), and the DSWD and other pertinent agencies, shall 
establish a comprehensive rehabilitation program for ESRD patients who have 
undergone kidney transplant in order to help them reach their fullest physical, 
psychological, social, vocational, avocational, and educational potential consistent with 
their physiologic or anatomic condition, environmental limitations, life plans and desires.
SEC. 11. Appropriations. - The initial amount necessary to implement the 
provisions of this Act shall be charged against the current year's appropriation of the


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DOH and other concerned departments/agencies. Thereafter, such sum as may be 
necessary for the continued implementation of this Act shall be included in the Annual 
General Appropriations Act.
SEC. 12. Implementing Rules and Regulations. - Within sixty (60) days from the 
effectivity of this Act, the Department of Health, in coordination with the President of 
PhilHealth, and the Executive Director of the NKTI, shall issue the implementing rules 
and regulations to implement the provisions of this Act.
SEC. 13. Separability Clause. - If any provision or part hereof is held invalid or 
unconstitutional, the remainder of the law or the provision not otherwise affected shall 
remain valid and subsisting.
SEC. 14. Repealing Clause. - Any law, presidential decree or issuance, executive 
order, letter of instruction, administrative order, rule or regulation contrary to or 
inconsistent with the provisions of this Act are hereby repealed, modified or amended 
accordingly.
SEC. 15. Effectivity. - This Act shall take effect fifteen (15) days after its 
publication in the Official Gazette or in a newspaper of general circulation.
Approved,