TWENTIETH CONGRESS OF THE ) 
REPUBLIC OF THE PHILIPPINES ) 
First Regular Session 
)
sen™
S.B. No.loII
of tljc
25 AUG 28 P4:25
RHCEiVED BV;
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."
Chronic kidney disease (CKD) remains a significant public health issue in the 
Philippines. It is among the top ten leading causes of death among Filipinos, as 
highlighted by the National Kidney and Transplant Institute (NKTI). The burden of this 
disease is growing at an alarming rate. In 2024 alone, the number of individuals 
undergoing dialysis reached a staggering 64,845, representing a 22% increase from 
the 53,296 patients recorded in 2023. This poses a severe and growing burden on the 
healthcare system and Filipino families, as the financial toll of treatment is simply 
unbearable for most.
In its commitment to Republic Act No. 11223, otherwise known as the "Universal 
Health Care Act," PhilHealth has taken important steps to expand coverage. In June 
2024, it increased the hemodialysis benefit package from PhP 2,600 to PhP 4,000 per 
session. However, PhilHealth itself subsequently acknowledged that despite this 
adjustment, many patients were still facing significant out-of-pocket expenses. Due to


this persistent financial gap, PhilHealth approved a further increase to PhP 6,350 per 
session, which began in October 2024. This expanded benefit now covers 156 
hemodialysis session per year, bringing the total annual financial protection for a 
patient to nearly PhP 1 million. Meanwhile, benefits for peritoneal dialysis increased up 
to PhP 1,269,000.
This bill seeks to further expand existing gains by a providing a comprehensive 
solution. It proposes to mandate PhilHealth coverage for all expenses for maintenance 
dialysis treatments, including medicines, professional fees, and hospital charges. 
Furthermore, recognizing that kidney transplantation provides the highest quality of life 
for End Stage Renal Disease (ESRD) patients, the bill mandate that PhilHealth shall also 
shoulder all expenses for kidney transplantation from living donors, including the costs 
for both the recipient and the donor, making this life-saving procedure truly accessible.
For the abovementioned reasons, the passage of this bill is earnestly sought.
: /l. /^)fCU€4///,
IMEE R. IvrARCOS


TWENTIETH CONGRESS OF THE ) 
REPUBLIC OF THE PHILIPPINES ) 
First Regular Session 
)
Senate
of ti)f 'sn crrmij’
25 AUG 28 P4:25/
S.B. No
SENATE
1311
RECEIVED BV;
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:
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Section 1. Short Title. - This Act shall be known as the "Comprehensive Dialysis
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and Rena! Replacement Therapy Act"
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Sec. 2. Declaration of Policy. - The State shall endeavor to make essential goods,
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health and other social services available to all the people at affordable cost, as well as
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to improve the delivery of health care services to the people and to ensure that hospital
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facilities are available, affordable, and accessible to all.
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It is a declared policy of the State to adopt an integrated and comprehensive
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approach to health development that will provide Comprehensive Renal Replacement
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Therapy (RRT) to improve the delivery of health care services to patients diagnosed
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with End Stage Renal Disease (ESRD), and to encourage them to have a kidney
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transplant, preferably within the first two (2) years of starting dialysis.
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Sec. 3. Definition of Terms. - As used in this Act, the following terms are defined
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as follows:
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a) Dialysis facility refers to a health facility that provides treatment for ESRD
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patients and disseminates information on the various forms of RRT such as
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kidney transplantation, peritoneal dialysis, and hemodialysis;


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b) End Stage Rena! Disease (ESRD) refers to the final stage of chronic kidney 
disease (CKD) in which the kidneys no longer function well enough to meet 
the needs of daily life;
c) Hemodialysis {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 {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 {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; and
i) Rena! replacement therapy {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.


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Sec. 4. CKD Prevention and Health Promotion. - All national, provincial, and
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regional government hospitals with dialysis services, as well as stand-alone dialysis
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facilities, shall establish and implement CKD prevention and health promotion programs,
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including advocacy activities targeting relatives of dialysis patients who are at high risk
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for developing CKD; the provision of instructional materials and regular educational
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activities on the common symptoms and risk factors of kidney disease, healthy diet and
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lifestyle, and common diagnostic tests; advisories on the appropriate protocols for the
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diagnostic evaluation of possible kidney disease; and patient education on the
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availability of essential medicines from government health centers, such as those for
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diabetes and hypertension, and the importance of regular medication intake and
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monitoring of kidney function through laboratory testing and regular clinic follow-up
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with a qualified physician.
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All activities pertaining to the aforementioned programs shall be properly
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documented for monitoring and evaluation purposes.
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Sec. 5. Philippine Rena! Disease Registry. - As a requirement for the renewal of
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their respective Department of Health (DOH) licenses to operate, all RRT facilities,
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including private and public hospitals, dialysis centers for both HD and PD, and
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transplant facilities, shall be mandated to report to the Philippine Renal Disease Registry
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of the DOH the incidence and prevalence of patients receiving PD or HD treatment, as
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well as those who have received a KT. The registration of all dialysis patients in the
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PhilHealth dialysis database shall be a prerequisite for the availment of benefits for both
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PD and HD.
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Sec. 6. PhilHealth Benefit for Dialysis Treatment. - The PhilHealth shall cover all
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expenses for maintenance dialysis treatments, including the professional fee of the
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attending physician, health facility charges, and medicines, in accordance with the
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implementing rules and regulations of Republic Act (RA) No. 11223, otherwise known
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as the "Universal Health Care Act."
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The No Balance Billing policy shall be strictly applied to ensure that no out-of-
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pocket expenses are incurred by the patients.


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Sec. 7. Dialysis Facility. - A dialysis facility shall be compliant with the licensing
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and accreditation requirements imposed by the DOH and the PhilHealth for HD and PD
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facilities. These requirements shall be in accordance with DOH Administrative Order No.
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2012-0001 dated 26 January 2012 and its subsequent amendments, as well as the
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relevant PhilHealth circulars and guidelines.
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Hospitals without dialysis facilities shall first establish the necessary equipment
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and qualified staff to perform PD services. For hospitals with existing HD facilities, a PD
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unit shall be established immediately so that this more cost-effective dialysis option can
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be made available to patients. Hospitals shall preferentially be provided with the
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necessary personnel, equipment, and supplies as required by PhilHealth for accredited
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facilities.
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Sec. 8. Training for Peritoneal and Hemodialysis Treatment and Services. - The
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DOH, National Kidney and Transplant Institute (NKTI), and the Philippine Society of
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Nephrology (PSN) shall jointly provide training for medical and non-medical personnel
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to support RRT services. This shall include, but not limited to, physicians, nurses, and
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technicians for both HD and PD centers, as well as barangay health workers to support
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homeObased PD. The training shall include hands-on workshops and cover all aspects
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of RRT. The NKTI, in collaboration with the DOH, shall accredit centers that can provide
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this specialized training.
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Sec. 9. PhilHealth Benefit for Kidney Transplantation. - In accordance with RA
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No. 11223, the PhilHealth shall cover all expenses for kidney transplantation from living
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donors. This shall include laboratory work-up for both recipient and donor candidate;
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hospitalization for the transplant operation, including induction immunosuppression and
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maintenance oral immunosuppression; organ retrieval and machine perfusion cost, and
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all required post-discharge and medication expenses. The cost for organ retrieval and
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machine perfusion shall be established by the DOH-Philippine Organ Donation Program.
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The PhilHealth shall also cover the evaluation and screening of the kidney donor
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and recipient, and post-transplantation procedures and remedies. This is inclusive of
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both pre- and post-kidney transplantation measures for the benefit of ESRD patients.


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To support kidney transplantation as the best treatment option for patients with
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ESRD, the PhilHealth and the Phiiippine Charity Sweepstakes Office (PCSO) shall provide
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support for all maintenance immunosuppression for the lifetime of the transplant
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patient, as long as the transplanted organ is functioning and the patient remains
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dialysis-independent.
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All RRT facilities shall be required to engage in regular organ donation advocacy
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activities. These activities shali include providing education for all Filipinos on carrying
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an organ donor card and establishing a potential deceased organ donor referral system
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to identify all potential donors to the Philippine Network for Organ Sharing.
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Sec. 10. Rehabilitation Program. - The DOH, in coordination with the Department
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of Labor and Employment (DOLE), Technical Education and Skills Development
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Authority (TESDA), and the DSWD and other pertinent agencies, shall establish a
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comprehensive rehabilitation program for ESRD patients who have undergone kidney
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transplant. The program's goal is to help patients reach their fullest physical,
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psychological, social, vocational, avocational, and educational potential, consistent with
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their physiologic or anatomic condition, environmental limitations, and life plans.
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Sec. 11. Appropriations. - The initial amount necessary to implement the
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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
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necessary for the continued implementation of this Act shall be included in the Annual
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General Appropriations Act.
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Sec. 12. Implementing Rules and Regulations. - Within ninety (90) calendar days
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from the effectivity of this Act, the DOH, in coordination with the PhilHealth, and the
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NKTI, shall promulgate the implementing rules and regulations necessary to implement
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the provisions of this Act.
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Sec. 13. Separability Clause. - If, for any reason, any provision or part hereof is
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held invalid or unconstitutional, the remainder of this Act or any section or provision
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hereof not otherwise affected shall remain valid and in full force and effect.


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Sec. 14. Repealing Clause. - Any law, presidential decree or issuance, executive
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order, presidential proclamations, letter of instruction, administrative order, rule or
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regulation, or part thereof which are contrary to or inconsistent with the provisions of
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this Act are hereby repealed, modified, or amended accordingly.
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Sec. 15. Effectivity. - This Act shall take effect after fifteen (15) days following
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its publication in the Official Gazette or in a newspaper of general circulation.
Approved,