Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

EIGHTEENTH CONGRESS
First Regular Session

HOUSE BILL No.__ 2620

Introduced by REPRESENTATIVES ANTONIO T. ALBANO and
RODOLFO B. ALBANO

EXPLANATORY NOTE

In the past decade, Rehabilitation Medicine as a field of specialization
experienced growth in all aspects. The number of trainees, graduates, and
certified diplomats and fellows has increased tremendously. There has also been
a markedly fast pace at which rehabilitation centers have sprouted throughout
the country, all with the noble intent of delivering expert rehabilitative care to
Filipinos suffering from neuromuscoskeletal, cardiovascular, pulmonary, and

other system disorders.

However, many of these rehabilitation centers are not headed by
physiatrists ( medical specialists who trained a minimum of three (3) years in
Rehabilitation Medicine) but by other medical and allied health professionals. By
the nature of their training, physiatrists are in the best position to head
rehabilitation centers and supervise the allied rehabilitative _ professionals:
physical therapist, occupational therapists, speech therapist, orthotists, and
prosthetists.


In the medical field, it is the physiatrist who is the specialist in medical
rehabilitation and who is trained to evaluate and treat patients with physical
disabilities from the rehabilitation standpoint, and to manage and administer
Rehabilitation Medicine departments, centers, clinics or other similar facilities.

It is the objective of this proposed Rehabilitation Medicine Act to set
standards for the training and practice of Rehabilitation Medicine as well as
technical and operational standards for rehabilitation centers to enable them to
function at the highest level of standards as headed and supervised by duly
trained and certified physiatrists. This way, the interests of the Filipino patients
who seek treatment from these centers are fully protected.

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


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Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

EIGHTEENTH CONGRESS
First Regular Session

HOUSE BILL re EAD

Introduced by REPRESENTATIVES ANTONIO T. ALBANO and
RODOLFO B. ALBANO

AN ACT
PROVIDING FOR STANDARDS FOR THE PRACTICE OF
REHABILITATION MEDICINE AND
FOR OTHER PURPOSES

Be in 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 “Medical
Rehabilitation Standards Act of 2019”

SEC. 2. Declaration of Policy. - It is the policy of the State to
protect and promote the right to health of the people by making the delivery
of expert rehabilitative care to Filipinos suffering from
neuromusculoskeletal, cardiovascular, pulmonary and other system
disorders which produce temporary or permanent disability accessible,
effective and affordable. Toward this end, standards for the effective
practice of Rehabilitation Medicine and for the establishment, management
and operations of rehabilitation facilities are hereby established.

SEC. 3. — Definitions. — As used in this Act, the following terms shall

mean:

a. Rehabilitation Medicine — the branch of medicine which deals with
the prevention, diagnosis, treatment and rehabilitation of


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neuromusculoskeletal, cardiovascular, pulmonary and other
system disorders which produce temporary or permanent disability
in patients as well as the performance of different diagnostic
procedures, including, but not limited to, electromyography and
other electrodiagnostic techniques. It also involves specialized
medical care and training of patients with loss of any function so
that they may obtain or be able to function to their maximum
potential, physically, psychologically, socially and vocationally,
providing special attention and care to prevent complications or
deterioration, and to assist in physiologic adaptation of disability.
In addition, the practice of Rehabilitation Medicine uses agents
such as heat, light, water, electricity, therapeutic exercise and
mechanical agents in its treatment armamentarium.

. Medical Rehabilitation — the process of helping a person reach the

fullest physical, psychological, social, vocational and educational
potential consistent with his or her physiologic or anatomic
impairments, environmental limitations and life plans.

. Physiatrist - a physician who is licensed and duly registered with

the Professional Regulation Commission and who completed three
(3) years of residency training in Rehabilitation Medicine in a
Philippine Board Rehabilitation Medicine-accredited _ training
institution.

|. Philippine Board of Rehabilitation Medicine (PBRM) — a non-stock,

non- profit corporation, duly recognized by the Professional
Regulation Commission and the Philippine Medical Association
composed of Board Certified Rehabilitation Medicine Specialists
tasked with accrediting and evaluating training institutions
specializing in Rehabilitation Medicine, and certifying graduates of
these training institutions.

. Rehabilitation Medicine Practitioner/Psychiatrist - a licensed

physician who completed a residency training program in
Rehabilitation Medicine in a Philippine Board of Rehabilitation


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Medicine (PBRM) accredited training institution. They shall be

qualified by the PBRM as:

A) Board Eligible Physiatrist — refers to one who completed
residency training in a PBRM-accredited residency training
program but who has not successfully completed the specialty
board examination.

B) Board Certified (Diplomate) ~ refers to those have passed Part I
(written) and Part II (oral) of the Diplomate Board Examination
given by the Philippine Board of Rehabilitation Medicine
(PBRM).

f. Rehabilitation Medicine Center/Facility/Unit - any facility that
renders services for the rehabilitation of physical disabilities and
which may be hospital-based of free-standing.

g. Rehabilitation Medicine Team — a group of medical and allied
health professionals concerned with the medical rehabilitation of
patients with physical disabilities. The team is headed by a
physiatrist and is composed of, but not limited to, the following:

1. Physical Therapists

. Occupational Therapists

. Prosthetists and Orthotists

. Rehabilitation Nurses

. Speech Pathologists

. Social Workers

. Vocational Counselors

8. Recreational Therapists

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SEC. 4. Scope of Practice. - The practice of Rehabilitation Medicine

includes:

a. Professional services related to the care of an individual patient,
rendered either as a physician primarily responsible for individual
patient care or as a consultant to another physician, and consists
of:


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. History taking, examination of patients, performance of specific
diagnostic procedures for the purpose of establishing diagnosis
and evaluation of disability, impairment, functional capacity
and potential for rehabilitation;

2. Prescription and rendering of appropriate medical treatment
which may include any or all aspects or physical medicine as
well as rehabilitative measures, including but not limited to
physical therapy, occupational therapy, speech therapy and
orthotic and prosthetic services.

3. Follow-up examination of patients in offices, hospitals,
rehabilitation facilities, extended care facilities or home for
purposes of re-evaluation and treatment modifications;

4. Appropriate consultation with other medical specialists;

5. Counseling and conference with non-physician health care
professionals or family concerning conduct of patient's care or
patient’s progress; and

6. Examination of patient’s records, preparation of reports,

designing, planning, and implementation of health programs for

the maintenance of health and prevention of disability; and
correspondence as well as appearance in court or providing
testimony pertaining to a patient.

. Professional services related to the administration of rehabilitation

facilities or units consist of :

1. Professional general supervision of rehabilitation services in a
hospital-based rehabilitation center or unit or any other free
standing units that render limited rehabilitation services,
convalescent home and private homes, for quality assurance
and appropriate utilization of services;

2. Planning, establishment and management of facilities,
equipment and personnel for the performance of functions and
activities of a rehabilitation department or unit, or any other
free standing unit that render limited rehabilitation services,


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convalescent home and private homes, for quality assurance
and appropriate utilization of services;

3. Maintenance of complete and accurate records and statistics;

4. Education of physicians and allied health care professionals in
Rehabilitation Medicine, both local and foreign, for programs
related to Rehabilitation Medicine;

5. Education of the public on health care issues pertaining to
Rehabilitation Medicine through research and medical
education;

6. Promoting professional development of Rehabilitation Medicine
through research and medical education;

7. Designing, planning and implementing of health programs for
maintenance of health and prevention of disability;

8. Establishing linkages with government and non-government
agencies, both local and foreign, for programs related to
Rehabilitation Medicine;

9. Promotion of the team approach among medical and allied
medical health care professionals in the holistic care of patients;
and

10. Setting standards for compensation of Rehabilitation
Medicine services.

. Guidelines for Practice in a Rehabilitation Medicine Facility:

1. Every patient shall be examined and diagnosed by a physiatrist.
The physiatrist recommends, prescribes and supervises an
individual treatment plan. The treatment plan and rehabilitation
program shall be regularly reviewed on a team basis.

2. Medications and various other therapies shall be prescribed by
a physiatrist.

3. The physiatrist has the primary responsibility of regularly
following-up on patients in his charge and modifying or
terminating treatment.


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A physiatrist shall head the facility/unit and shall supervise the
delivery of rehabilitation medicine services rendered by other
members of the Rehabilitation Medicine team. In areas where
there is no physiatrist, a licensed physician shall head the
facility unit.

If a physicians is not competent to manage a patient, he shall

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consult or refer to another physiatrist or physician who is
competent in the particular disease or condition requiring
treatment.

6. A Board certified physiatrist may head not more than three (3)
Rehabilitation Medicine facilities. In the absence of a Board
Certified physiatrist, a Board eligible physiatrist may head the
facility, provided that he conforms to the requirements of the
PBRM.

7. The physiatrist shall charge professional fees in accordance with
the standards of the Philippine Medical Association and the
Philippine Health Insurance System (PHILHEALTH).

8. The physiatrist shall conduct himself in a manner consistent
with the Code of Ethics of the Philippine Medical Association.

SEC. 5. Qualifications to Practice. — A physician who is a Board
Certified/Board Eligible physiatrist, of good moral character and is a
member of the Philippine Medical Association is qualified to practice
Rehabilitation Medicine.

SEC. 6. Accreditation and Certification. — This Act aims to establish
the standards for the practice of Rehabilitation Medicine and the
certification of Rehabilitation Medicine practitioners in order to ensure the
highest quality of professional rehabilitation service to the public and to the
medical community.

a. Accreditation of the Physiatrist
1. A Rehabilitation Medicine Practitioner eligible _ for
accreditation is a graduate of a Philippine Board of


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Rehabilitation Medicine (PBRM) - accredited Rehabilitation
Medicine training institution and certified by the PBRM as:
1.a Board certified (Diplomate)

1.b Board Eligible

2. A Rehabilitation Medicine Practitioner is duly recognized as

PBRM Board Certified upon compliance with and submission
of the following requirements;

2.a. Authenticated Professional Regulation Commission
(PRC) ID as a duly registered physician.

2.b. Certificate of completion of training in a PBRM
accredited Rehabilitation Medicine training institution.

2.c. Certificate from the Philippine Board of Rehabilitation
Medicine (PBRM).

3. A Rehabilitation Medicine Practitioner is duly recognized as

PBRM Board Eligible upon compliance with and submission
of the following requirements:

3.a, Authenticated Professional Regulation Commission
(PRC) ID as duly registered physician

3.b. Certificate of completion of training in a PBRM
accredited Rehabilitation Medicine training institution.

3.c. Certificate of Eligibility from PBRM.

4. A Rehabilitation Medicine Practitioner, who is duly
recognized as PBRM Board Eligible, must upgrade to a PBRM
Board Certified status within five (5) years after graduation
from a PBRM-accredited Rehabilitation Medicine training
institution. Forfeiture of this Board eligibility status is
incumbent upon review and evaluation of the PBRM Board of
Governors.


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b. Continuing Certification of Rehabilitation Medicine Specialists - A
Certified Diplomate of the Philippine Board of Rehabilitation Medicine,
in order to be duly recognized as a rehabilitation Medicine specialist,
must undergo re-certification every three (3) years through PBRM
accreditation.

SEC. 7. - Technical Standards and Requirements for the
Registration, Operation and Maintenance of Rehabilitation Medicine
Facilities. - Technical standards and requirements for the registration,
operation and maintenance or rehabilitation medicine facilities shall apply
to all entities performing the activities and functions of Rehabilitation
Medicine facilities. These shall include the evaluation and treatment of all
conditions requiring rehabilitation of physical disabilities. These standards
and requirements shall be formulated to protect and promote the health of
the people through the implementation of standards to ensure proper
management and adequate support for Rehabilitation Medicine facilities.

SEC. 8. Regulatory Authority - technical standards and
requirements for the registration and maintenance of Rehabilitation
Medicine Facilities in the Philippines shall be implemented and regulated by
the Department of Health-Bureau of Health Facilities and Services (DOH-
BHFS).

SEC. 9. Classification of Facilities - Rehabilitation Medicine
facilities shall be classified according to the institutional character, and
extent of services offered. The bases for the classification of the different
categories of Rehabilitation facilities are: (1) Physiatrist qualification, (2)
Allied Health personnel staff qualification, (3) rehabilitation Medicine
services available and (4) Physical set-up and equipment.

a. Categories
1. As to institutional character, Rehabilitation Medicine facilities
are either hospital based (if operating within a hospital set-up)
or free standing (if operating on its own or part of a facility other
than a hospital).


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2. As to the extent of services, Rehabilitation Medicine facilities
maybe primary, secondary , tertiary, or home-based.

3. As to function, a Rehabilitation Medicine facility may be utilized
for training services and research or for services alone.

4. As to services, a rehabilitation Medicine facility can also be
either general or specialized.

. A primary rehabilitation Medicine facility shall have the following:

1. At least one (1) PBRM eligible physiatrist;

2. At least one (1) allied rehabilitation health professional;

3. Rehabilitation Medicine consultation and management with
physical therapy services;

4. Physical set-up;

5. Medical consultation area;

Treatment area to include at least an electro therapy device and

superficial heating modality, and ADFL training devices;

7. Gym area, to include parallel bars, mirror, weights and assistive

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devices such as canes, crutches and walkers among others;

8. Evaluation tools;

9. Adequate utilities such as water, electricity and consumables;
and

10. First Aid kit with basic CPR equipment

- A secondary Rehabilitation Medicine facility shall have the

following:

1. At least one (1) PBRM Board certified Physiatrist;

2. At least one (1) licensed therapist and occupational therapist;

3. Rehabilitation Medicine consultation and management, physical
therapy and occupational therapy services; and

4. Compliance with the primary category set-up plus deep heating
modality, manual traction and therapeutic exercise equipment
for the gym area.

d. A tertiary Rehabilitation Medicine facility shall have the following:


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1. At least one (1) PBRM Board certified physiatrist;

2. At least one (1) licensed physical therapist and occupational
therapist;

3. Rehabilitation Medicine consultation and management,
physical, occupational therapy, prosthetist and orthotist in-
house or referral services, speech therapy in-house or referral
services;

4. Compliance with the secondary category set-up and
equipments, with additional two (2) superficial healing
modalities, medium frequency modality, mechanized traction,
ultraviolet or cold laser intermittent compression unit,
mechanized intermittent traction and tilt table with additional
gym equipment.

5. A Training/Service and Research facility, which shall fulfill all
the requirements as a residency training institution in
accordance with PBRM guidelines.

6. A specialized facility which should cater to sub-specialty
conditions in rehabilitation medicine including cardiac, pain,
pediatric, pulmonary, sports, among others, shall be a hospital-
based facility with a multi-disciplinary set-up.

SEC. 10. Management and Operation of a Rehabilitation Medicine
Facility. - A Rehabilitation Medicine Facility shall be headed by a
Rehabilitation Medicine specialist who is either a PBRM Certified or Eligible
Rehabilitation Medicine specialist in the said facility. An adequate and
effective system of documentation, recording and records keeping must be
maintained for all consultations and services in the facility. The rates for
consultation and services shall be in accordance with the standards of the
Philippine Medical Association and PHILHEALTH.

SEC. 11. Application for Registration and Issuance of License. -
Applications for registration and issuance of a license shall be filed by the
owner of the facility or his duly authorized representative with the DOH-
Bureau of Health Facilities and Services (DOH-BHFS), together with an