Republic of the Philippines
HOUSE OF REPRESENTATIVES
Batasan Hills, Quezon City

EIGHTEENTH CONGRESS
First Regular Session

House Bill No. 3273

Introduced by
HON. YEDDA MARIE K. ROMUALDEZ
an
HON. FERDINAND MARTIN G. ROMUALDEZ

INSTITUTIONALIZING MALASAKIT CENTERS To COMPLEMENT THE
IMPLEMENTATION OF REPUBLIC ACT NO, 11223 OTHERWISE KNOWN AS
THE “UNIVERSAL HEALTH CARE ACT” BY REQUIRING PHILHEALTH TO

MAI CENTERS IN ALL DOH,
LGU, SUC and DND HOspPrTALs IN THE COUNTRY, PROVIDING FUNDS
THEREFOR, AND FOR OTHER PURPOSES

EXPLANATORY NOTE

Region. However, today, it is not uncommon for an indigent patient or his/her relative
to knock on the doors of various government agencies to avail of financial assistance

In 2018, a ‘one-stop shop dubbed as “Malasakit Center” was launched by the
government in the Vicente Sotto Memorial Medical Center (VSMMC) in Cebu City. Seen
to effectively ease the process of availing government Services for Patients, more


Masakit Centers were established. By the first half of 2019, there were about 34
Malasakit Centers all over the country.

Currently, the Malasakit Centers houses desk representatives from the
Department of Health (DOH), Department of Social Welfare and Development
(DSWD), Philippine Health Insurance Corporation (Philhealth) and Philippine Charity
‘Sweepstakes Office (PCSO).

With the enactment of Republic Act No. 11223 or the “Universal Health Care
Act", every Filipino citizen is automatically included in the National Health Insurance
Program. Even in anticipation of how UHC will bring about a dramatic change in how
Patients can more freely access individual health care through secured health
financing through PhilHealth and more effective and efficent implementation of public
health programs by the DOH for population-based services for the community, the
challenge remains in how we can close the gap between indigent, marginalized
families and those who can afford availing of basic and specialty medical services in
both the outpatient clinics and the hospital in-patient setting.

The benefits under the Universal Health Care (UHC) rely on health benefits
package as determined by the Philhealth. As such, out-of-pocket expenditures may
stil arise if the benefit packages are not enough to cover the medical needs of indigent
and Poor patients. In 2017, despite the safety nets of Philhealth, out-of-pocket
Payment accounted for 55% of health expenditures, according to the Philippine
Statistics Authority.

This proposed measure intends to reduce, if not eliminate, out-of-pocket
expenditures of indigent and poor Patients including non-medical expenses like
transportation costs. Malasakit Centers will also be a Health System Enabler to improve
assessment for patient assistance and referral to Provide much needed system
support for patient navigation.

This bill seeks to establish, maintain and ‘Operate Malasakit Centers in all DOH,
LGU, DND and SUC hospitals in the country which will house desk representatives
from the Philhealth, DOH and DSWD. The Philhealth representative shall be in charge


of assisting and processing the concerns of both direct and indirect contributors to
Philhealth regarding the implementation of Republic Act No. 11223 or the "Universal
Health Care Act” which may include concerns on coverage, billing, health benefits
Packages, among others. The DOH representative shall be in charge of providing
medical assistance, while the DSWD representative will be providing financial or direct
assistance. This way we can deliver basic services to communities in the most efficient,
responsive and sustainable manner.

In view of the foregoing, approval of this bill is earnestly sought.

Rep. YEDD/ IE K. ROMUALDEZ
Representativel/Tingog Sinirangan



Republic of the Philippines
HOUSE OF REPRESENTATIVES
Batasan Hills, Quezon City

EIGHTEENTH CONGRESS
First Regular Session

House Bill No,_3273

Introduced by
HON. YEDDA MARIE K. ROMUALDEZ

and
HON. FERDINAND MARTIN G. ROMUALDEZ

AN ACT
INSTITUTIONALIZING MALASAKIT CENTERS TO COMPLEMENT THE
IMPLEMENTATION OF REPUBLIC ACT NO. 11223 OTHERWISE KNOWN AS
THE “UNIVERSAL HEALTH CARE ACT” BY REQUIRING PHILHEALTH TO
ESTABLISH, OPERATE AND MAINTAIN MALASAKIT CENTERS IN ALL DOH,
LGU, SUC and DND HOSPITALS IN THE COUNTRY, PROVIDING FUNDS
THEREFOR, AND FOR OTHER PURPOSES

Be it enacted by the Senate and House of Representatives of the Philippines in
Congress assembled:

SECTION 1. Short Title. - This Act shall be known as the “Malasakit Centers
Act of 2019.”

SEC. 2. Declaration of Policies. - \t is the declared policy of the State to
improve the delivery of health care services to the people, and to ensure financial
assistance for hospital and medical expenses are available and accessible to the

people.

SEC. 3. Definition of Terms. - For purposes of this Act, the following terms

shall mean:
(a) DOH Hospital refers to a refers to a hospital under the management and
administration of the Department of Health (DOH), including the four (4)


corporate hospitals under the Secretary of Health, namely: Philippine Heart
Center, Lung Center of the Philippines, National Kidney and Transplant Institute
and the Philippine Children's Medical Center;

(2) DND Hospital refers to a hospital managed by the Department of National
Defense;

(©) Financial Assistance or Material Assistance refers to actual cash or check which
covers burial, transportation, and other allied assistance given by agencies as
mandated by existing laws, rules and regulations to provide such assistance;

(d) indigent Patient refers to patient who has no visible means of income, or whose
income is insufficient for the subsistence of his/her family, as identified by the
Department of Social Welfare and Development (DSWD), LGU social worker or
the medical social worker of the health facility;

(€) Local Government Unit (LGU) Hospital refers to a hospital managed by the local
government units, usually the provincial government;

(A) Malasakit Center refers to a processing center for Philhealth and one-stop shop
for Filipinos in need of medical assistance;

(g) Medical Assistance refers to assistance for out-of-pocket expenditure in form of
coupon, stub, guaranty letter, promissory note or voucher that has monetary
value, given directly to individual recipients or beneficiaries to address their
immediate needs;

(h) Out-of- pocket expenditure refers to medical and surgical services not currently
paid for or sufficiently reimbursed by PhilHealth under Republic Act No. 11223
or the Universal Health Care Act, or other financing sources;

() Poor Patient refers to those not classified as indigent but are otherwise
considered poor or with financial difficulty to access adequate medical care
and/or pay hospital bills because of certain unavoidable circumstance, such as
but not limited to:

. Senior citizens, persons with disability (PWD), orphans, abused women and
children as defined by RA 9262 or the Anti-Violence Against Women and
Their Children Act of 2004 and RA 7610 or the Special Protection of Children
Against Abuse, Exploitation and Discrimination Act;

. Patients with catastrophic illness or any illness as a primary condition that

N


is life or limb-threatening and requires prolonged hospitalization, extremely
expensive therapies or other special but essential care that would deplete
one's financial resources, unless covered by special health funding policies;
3. Unemployed or without gainful employment;
4. Suspected or confirmed victims of torture as defined by Republic Act
No.9745 or the Anti-Torture Act of2009;
. Soldiers and police rendered disabled to be gainfully employed and their
dependents and dependents of soldiers and police killed in action;

wo

6. Rebel returnees, prisoners of war and their dependents;

7. Victims of calamities or disasters such as but not limited to typhoons,
earthquake, whose place of residence are officially under a state of
emergency or calamity; and

() SUC Hospital refers to hospitals managed by State Universities and Colleges.

SEC. 4. Malasakit Centers. — To complement the implementation of Republic
Act No. 11223, otherwise known as the Universal Health Care Act, there shall be
established a Malasakit Center in each DOH, LGU, DND and SUC hospital in the country
which shall serve as (a) processing center for all Philhealth concerns regarding
coverage, billing, health benefits packages, patient navigation and referral to the
health care provider network, and (b) one-stop shop medical assistance to cover out-
of-pocket medical expenses of indigent and poor patients.

The Philhealth shall administer and manage the Malasakit Centers in close
coordination with the DOH and DSWD. Each Malasakit Center shall consist of duly
designated representatives from the Philhealth, DOH and DSWD with the following
delegation of functions:

1, The Philhealth representative shall be in charge of the over-all operation of
the Malasakit Center. He/she shall assist and process the concerns of both
direct and indirect contributors to Philhealth regarding the implementation
of Republic Act No. 11223, including but not limited to coverage, billing,
health benefits packages, financial concerns. The Philhealth representative
shall also assist in patient navigation and referral to the health care provider
network;


2. The DOH representative shall be in charge of providing medical assistance
to indigent and poor patients; and

3. The DSWD representative shall be in charge of providing financial or direct
assistance to indigent and poor patients.

SEC 5. Provision of Medical Assistance. — The DOH shall provide medical
assistance to indigent and poor patients through the Malasakit Center which shall be
charged from the annual appropriation of the DOH for assistance to indigent patients.
The DOH may also augment medical assistance using the following sources:

a) Other appropriations earmarked by national government agencies and local
government units purposely for medical assistance to indigent and poor
patients: Provided, That appropriations earmarked for a specific hospital shall
only be used for that specific hospital; and

b) Donations and grants-in-aid: Provided, That donations and grants donated
for a specific hospital shall only be used for that specific hospital: Provided
further, That the donations ang grants shall only be used for the purpose
specified by the donor.

The DOH shall issue guidelines for the proper implementation of the medical
assistance to indigent and poor patients which shall include order of charging from
the aforementioned sources of financing, availment procedures, transfer and release
of funds, recording and reporting, monitoring and evaluation, partnerships with private
hospitals, among others.

The DOH shall make a quarterly report to the Office of the President and
Congress regarding the expenditures or disbursement of the medical assistance to
indigent and poor patients.

SEC 6. Medical Assistance. - The Medical Assistance shall cover for
medical and surgical services not currently paid for or sufficiently reimbursed by
PhilHealth in accordance with Republic Act No. 11223 or other financing sources, and
shall be used for the following drugs, medicines, goods and other services prescribed


by the physician of the health facility such as but not limited to:

a.
b.

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Laboratory, imaging and all other diagnostic procedures;
Drugs and medicines included in the Philippine National Drug Formulary
(exemptions to be cleared by Pharmaceutical Division);

Supplies, orthopedic/assistive devices, prosthesis, blood and blood products;

. Dental services, except those that are for aesthetic purpose and not medically

indicated;

. All clinically indicated medical and surgical procedures, whether emergency

or elective;

. Prescribed post-hospitalization rehabilitation services, aftercare program,

appropriate mental and psychological support, including those done on an
outpatient basis;

. In case of non-availability of clinically indicated drugs, medicines, tests,

services or procedures in government health facilities, the concerned
government health facility may enter into contract with DOH-accredited
private health facility to provide the needed drug, test, service or procedure
to the patient, charged against the DOH hospital;

. All hospital bills including professional fees, provided that the expenses for

professional fees shall not exceed fifty percent (50%) of the approved
assistance; and

All other medical, health, documentary and related services billed by the
hospital.

Provided, That medical assistance to patients shall be based on need as
recommended by the medical social worker attending physician, approved by the Chief
of Hospital/Medical Center Chief of the institution involved and DOH authorized
Officials, subject to availability of funds.

SEC. 7. Provision of Financial Assistance. - The DSWD shall provide

financial assistance through the Malasakit Center to indigent and poor patients,
individuals in emergency situations, under distress or are in need of supplemental
financial support due to health or medical conditions, sickness or disease; funeral and


burial concerns, which also includes the most direct and economical transportation
expense to or from place of residence or specific destination.

The provision of financial assistance through Malasakit Centers shall be charged
to the annual appropriation of the DSWD for assistance to individuals and families in
difficult circumstances. The DSWD shall issue policies and guidelines on the release of
such assistance for the proper implementation of the program.

SEC. 8, Establishment of Malasakit Centers. - The Philhealth and DOH
shall, in the establishment of the Malasakit Centers, undertake consultations with all
DOH, LGU, DND and SUC hospitals; Provided, That in the establishment of the
Malasakit Centers, highest priority shall be given to those economically-depressed
areas or provinces.

Within three (3) years from the effectivity of this Act, the Philhealth and DOH
shall establish Malasakit Centers down to the Primary and Secondary Care level to
help facilitate the adoption of appropriate health seeking behaviors, assist primary
care providers in encouraging medical consultation at the health centers, monitor
patient compliance, and ensure proper patient referral and availment of benefits.

Private hospitals are hereby encouraged to establish Malasakit Centers. The
Philhealth and DOH may enter into a Memorandum of Agreement with private
hospitals for the establishment of Malasakit Centers which shall cater indigent and
poor patients of the private hospital.

SEC. 9. Donations from Non-Governmental Organizations and the
Private Sector. - The DOH may solicit and receive donations from the private sector
for medical assistance to indigent and poor patients. Such donations shall be exempt
from income or donor's tax and all other taxes, fees and charges imposed by the
government: Provided, That donations from the private sector for a particular hospital
shall only be used for the benefit of the patients of the particular hospital: Provided
further, That the donations ang grants shall only be used for the purpose specified by
the donor. As such, the donor may send his or her representatives to the Malasakit


Center for the provision of the medical assistance donated by the donor in the
particular hospital.

Receipts from donations, whether in cash or in kind, shall be accounted for in
the books of the DOH in accordance with accounting and auditing rules and
regulations. The receipts from cash donations and proceeds from sale of donated
commodities shall be deposited with the National Treasury and recorded as a special
account in the General Fund and shall be available to the DOH through a special
budget pursuant to Section 35, Chapter 5, Book VI of Executive Order No. 292.
Donations with a term not exceeding one (1) year shall be treated as trust receipts.

The DOH shall submit the quarterly reports of all donations received, whether
in cash or in kind, and expenditures or disbursements thereon with electronic signature
to the DBM, through the Unified Reporting System, and to the Speaker of the House
of Representatives, the President of the Senate of the Philippines, the House
Committee on Appropriations, the Senate Committee on Finance and the Commission
on Audit, by posting such reports on the DOH website for a period of three (3) years.
The head of the DOH shall send written notice to the said offices when said reports
have been posted on its website which shall be considered the date of submission.

SEC 10. Appropriations. - The amount necessary to establish Malasakit
Centers shall be included in the General Appropriations Act. Additionally, there shall
be an annual appropriation for the assistance to indigent patients under the DOH
specifically for medical assistance to indigent and poor patients as provided for in
Section 5 of this Act, and an annual appropriation for assistance to individuals and
families in difficult circumstances under the DSWD budget for financial assistance to
indigent and poor patients as provided for in Section 7 of this Act.

SEC 11. Implementing Rules and Regulations. - Within ninety (90) days
from the approval of this Act, Philhealth, DOH, DSWD, in coordination with
Department of Interior and Local Government shall jointly issue the implementing
rules and regulations of this Act.

SEC. 12. Separability Clause. - Any portion or provision of this Act that is


declared unconstitutional shall not have the effect of nullifying other portions or
provisions hereof as long as such remaining portions can still subsist and be given
effect in their entirety.

SEC. 13. Repealing Clause. - All laws, ordinances, rules, regulations, other
issuances or parts thereof, which are inconsistent with this Act, are hereby repealed
or modified accordingly.

SEC. 14. Effectivity. - This Act shall take effect fifteen (15) days after its
publication in the Official Gazette or in a newspaper of general circulation.

Approved,