Republic of the Philippines 
HOUSE OF REPRESENTATIVES 
Quezon City, Metro Manila 
NINETEENTH CONGRESS 
Second Regular Session 
HOUSE BILL NO.  9289 
Introduced by HON. EDGAR M. CHATTO 
First District, Bohol 
EXPLANATORY NOTE 
“One Filipino suffers chronic kidney failure every hour”. 
- National Kidney and Transplant Institute
Some 2.6 million patients worldwide undergo dialysis or transplantation, but 
2.3 million succumb to premature deaths due to lack of access to dialysis and 
transplantation. 
From the 7th leading cause of death of Filipinos, Chronic Kidney Disease (CKD) 
has now become the 4th most common cause of death in the Philippines in 2019 after 
ischemic heart disease, stroke, and lower respiratory infection. Tuberculosis was fifth.1 
According to the extrapolation report of the National Kidney Institute from data 
collected since 2016, “At least 7 million Filipinos are suffering from chronic kidney 
disease (CKD) as of 2021, with one Filipino every hour getting the disease”.2  The NKTI 
affirms that one Filipino develops chronic renal failure every hour or about 120 Filipino 
per million population per year. The cost of medical treatment for kidney disease is 
really exorbitant, beyond the reach of ordinary patients. Real transplantation is limited 
due to the expense and the shortage of donors.”3 
In the words of the Department of Health “CKD can progress to more severe 
complications such as End-Stage Kidney Disease (ESKD) that now requires more 
immediate and regular interventions. These interventions include renal replacement 
therapies ranging from hemodialysis to renal transplant. The increasing numbers of 
CKDs have become an urgent national concern due to the burden of the disease and 
high costs of care”.4 
Kidney diseases, according to the Adult Nephrology Department of the NKTI, 
are treatable and while kidney failure was uniformly associated with death, current 
1 https://www.pna.gov.ph/articles/1202791 
2 https://www.pna.gov.ph/articles/1202791 
3 https://www.nkti.gov.ph/index.php/patients-and-visitors/kidney-health-plus 
4 https://doh.gov.ph/health-programs?page=2 
September 22, 2023
3:53 pm


kidney patients enjoy an extended life up yo 20 years, and transplant patients live 
almost normal.5 
 
 This proposed legislative measure answers the call for the availability, 
affordability and accessibility to necessary medical health service, specifically free 
dialysis treatments to indigents, through the government hospitals at the national, 
regional, provincial and municipal levels. This will complement Philhealth’s recent 
increase in free coverage of member-patients  from 90 to 156 dialysis sessions per year. 
 
More than the mere extension of life, this proposed measure aims at improving 
the quality of life of our citizens suffering from chronic kidney diseases all over the 
country. 
 
Taking into account the points raised, immediate passage of this bill is earnestly 
sought.  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
REP. EDGAR M. CHATTO 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
5 https://today.mims.com/the-state-of-kidney-disease-in-the-philippines-preventable-treatable-but-lacking-in-
donors  


Republic of the Philippines 
HOUSE OF REPRESENTATIVES 
Quezon City, Metro Manila 
NINETEENTH CONGRESS 
Second Regular Session 
HOUSE BILL NO.  9289 
Introduced by HON. EDGAR M. CHATTO 
First District, Bohol 
“AN ACT  
REQUIRING ALL NATIONAL, REGIONAL AND PROVINCIAL 
GOVERNMENT HOSPITALS TO ESTABLISH, OPERATE AND MAINTAIN A 
DIALYSIS WARD OR UNIT IN THEIR RESPECTIVE HOSPITALS AND 
PROVIDING FREE DIALYSIS TREATMENT TO INDIGENT PATIENTS” 
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 “Dialysis Center 
Act.” 
SECTION 2. Declaration of Policy. – It is the policy of the State to improve 
the delivery of health care services to the people and to ensure hospital facilities are 
available, affordable and accessible to the people. 
SECTION 3. Definition of Terms. – 
a.
Secretary refers to the Secretary of the Department of Health (DOH);
b.
National Government Hospital refers to a hospital operated and maintained
either partially or wholly by the national government or by any department,
division, board, or other agency thereof;
c.
Regional Government Hospital refers to a hospital operated and maintained
either partially or wholly by the regional government or by any department,
division, board, or other agency thereof;
d.
Provincial Government Hospital refers to a hospital operated and
maintained either partially or wholly by the provincial government or by any
department, division, board, or other agency thereof; and
e.
Indigent Patients refers to a patient who has no visible means of income, or
compensation to support his/her basic need as determined by the
Department of Social Welfare and Development (DSWD).
SECTION 4. Establishment, Operation and Maintenance of a Dialysis 
Ward or Unit. - Within two (2) years from the effectivity of this Act, all national, 


regional and provincial government hospitals, are hereby required to establish, operate 
and maintain a dialysis ward or unit in their hospital. The dialysis ward or unit shall be 
equipped with complete dialysis machine, equipment and supplies. 
 
SECTION 5. Free Dialysis Treatment to Indigent Patients. - Dialysis 
treatment in all national, regional and provincial government hospitals shall be 
provided free of charge to indigent patients as defined in Section 3 (e) hereof. 
 
SECTION 6. Penalty. - Any hospital chief, administrator or officer-in-charge 
who fails to comply with this Act shall be punished with a fine of Fifty Thousand pesos 
(Php 50,000.00) but not more than One Hundred Thousand Pesos (Php 100,000.00). 
 
SECTION 7. Implementing Rules and Regulations. – The Secretary shall 
promulgate the necessary rules and regulations relevant to implement the provisions of 
this Act.  
 
SECTION 8. Appropriations. – Such amount as may be necessary to 
implement the provisions of this Act is hereby authorized to be appropriated from the 
General Appropriations Act. Thereafter, the amount necessary for the continuous 
implementation of this Act shall be included in the annual appropriation of the 
government hospital.  
 
SECTION 9. Separability Clause. – If any provision of this Act shall be held 
unconstitutional, any other provisions not otherwise affected  shall remain in full force 
and effect.  
 
SECTION 10. Repealing Clause. – All laws, executive orders, rules and 
regulations, or parts thereof inconsistent with the provisions of this Act are hereby 
amended, repealed or modified accordingly.  
 
SECTION 11. Effectivity. – This Act shall take effect after its complete 
publication in the Official Gazette or in at least two (2) newspapers of general 
circulation. 
 
 
Approved,