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Republic of the Philippines 
HOUSE OF REPRESENTATIVES 
Quezon City 
NINETEENTH CONGRESS 
Third Regular Session 
HOUSE BILL NO. 11298 
Introduced by Representative Wilbert “Manoy” T. Lee 
AN ACT 
 GRANTING AMNESTY FOR CASES INVOLVING HOSPITALS AND 
DOCTORS AND PAYMENT OF DENIED CLAIMS DUE TO LATE FILING  
AND PENALTY REDUCTIONS FOR EMPLOYERS, TOWARD THE FULL 
AND GENUINE REALIZATION OF THE UNIVERSAL HEALTH CARE LAW 
EXPLANATORY NOTE 
The Universal Health Care (UHC) Law, as provided for in Republic Act No. 11223, 
envisions equitable access to comprehensive, quality, and affordable health services for all 
Filipinos. Despite the law’s promising and revolutionary objectives, its full realization has 
been hindered by systemic barriers, between healthcare providers (hospitals and doctors) and 
the Philhealth Health Insurance Corporation (PhilHealth). These challenges prevent a 
seamless transition to universal health coverage, undermining the sustainability of our 
country’s healthcare system leading to delays in the timely access to essential health services 
for many Filipinos. To overcome these barriers and ensure the full and genuine realization of 
the UHC Law is essential. 
In order to guarantee access to healthcare services, the government's coordination and 
relationship with healthcare providers is crucial, particularly on the implementation of the 
UHC Law. However, the government and health care services providers are confronted with 
legal battles resulting from payment delays, disparities in claims processing, and other 
compliance difficulties. There have been calls urging the PhilHealth to grant amnesty to 
suspected fraudulent cases that have not been resolved for more than a year1 in order to clear 
legal backlogs, enabling healthcare providers to focus on patient care rather than lengthy 
dispute resolutions thereby creating a more conducive environment for effective healthcare 
delivery. Likewise, amnesty by facilitating the payment of denied claims due to late filing 
1 Cabrera, R. (1 November 2024) Grant amnesty to hospitals with unresolved cases, PhilHealth urged. Accessed 
last 12 January 2025 from: https://www.philstar.com/headlines/2024/11/01/2396839/grant-amnesty-hospitals-
unresolved-cases-philhealth-urged 
January 15, 2025
6:13 pm


 
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will help healthcare providers recover from financial strains and ensure continued operation 
and the availability of services to the public. A reinvigorated healthcare sector will directly 
benefit the population, particularly vulnerable groups who depend on public healthcare 
services. 
 
On the same note, employers play a crucial role in supporting the Universal Health 
Care Law by contributing to the financing of the health system through premium payments. 
However, many employers have been penalized for late or non-payment of contributions, 
often due to genuine business challenges especially during the pandemic. The lowering of 
surcharge penalties will encourage employers to settle their dues without facing prohibitive 
penalties, thereby increasing revenue for the health system and foster a more inclusive 
approach to employer compliance, ensuring that micro, small and medium-sized enterprises 
(MSMEs) are not unfairly penalized, while ensuring that they contribute to the national 
insurance fund. 
 
By granting amnesty for legal cases involving healthcare providers, facilitating the 
payment of denied claims, and reducing penalties for employers, this measure aims to 
streamline processes, foster cooperation, and ultimately accelerate the attainment of universal 
healthcare for all citizens. 
 
 
In view of the foregoing, the approval of this bill is earnestly sought. 
 
 
 
 
 
 
   
 
 
 
 
 
 


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Republic of the Philippines 
HOUSE OF REPRESENTATIVES 
Quezon City 
NINETEENTH CONGRESS 
Third Regular Session 
HOUSE BILL NO. 11298 
Introduced by Representative Wilbert T. Lee 
AN ACT 
 GRANTING AMNESTY FOR CASES INVOLVING HOSPITALS AND 
DOCTORS AND PAYMENT OF DENIED CLAIMS DUE TO LATE FILING  
AND PENALTY REDUCTIONS FOR EMPLOYERS, TOWARD THE FULL 
AND GENUINE REALIZATION OF THE UNIVERSAL HEALTH CARE LAW 
Be it enacted by the Senate and House of Representatives of the Philippines in 
Congress assembled: 
SECTION 1. Declaration of Policy. It is the policy of the State to ensure equitable 
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access to quality health care for all citizens, consistent with the goals of the Universal Health 
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Care Law. In pursuit of this objective, it is necessary to address outstanding legal issues 
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involving health care providers, eliminate barriers to payment for health care services, and 
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foster cooperation between the government, hospitals, doctors, and employers in 
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implementing universal health coverage. 
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SEC. 2. Amnesty for Pending Cases Involving Hospitals and Healthcare 
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Providers. Any pending case filed against hospitals, healthcare providers, or medical 
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professionals, including doctors, before the Philippine Health Insurance Corporation 
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(PhilHealth) arising from suspected fraudulent activities, which have remained unresolved for 
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a period exceeding one (1) year, shall be deemed automatically dismissed. This dismissal 
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shall be without prejudice to the initiation of any further legal proceedings before a 
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competent court of law. 
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SEC 3. Reconsideration of Denied Claims. Reconsideration of denied claims for 
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medical services rendered that were denied by PhilHealth solely on the basis of late filing, 
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with filing dates no later than January 1, 2018, shall be subject to reconsideration by 
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PhilHealth. The health service provider, hospital, or medical professional must demonstrate 
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that the late filing was caused by circumstances beyond their reasonable control, including 
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but not limited to technical errors, health emergencies, or other similar factors. PhilHealth 
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shall review and process all resubmitted claims in a timely and efficient manner. Claims 
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found to be valid following resubmission shall be approved and paid without the imposition 
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of any penalties or fines for the late submission. 
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SEC 4. Amnesty for Interest, Surcharge Penalties for Employers.  Employers who 
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are subject to interest, surcharges and penalties for non-compliance with the payment of 
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health premiums from January 1, 1995 shall be granted amnesty, provided they settle the 
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original surcharge amount and the principal premium contribution. Application for Amnesty 
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Employers wishing to avail themselves of this amnesty provision must submit a formal 
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application to both PhilHealth and the Department of Labor and Employment (DOLE) in 
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accordance with the prescribed procedures. 
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SEC 5. Repealing Clause. – All laws, acts, decrees, executive orders, issuances, and 
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rules and regulations or parts thereof which are contrary to and inconsistent with this Act are 
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hereby repealed, amended, or modified accordingly. 
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SEC 6. Repealing Clause. – All laws, acts, decrees, executive orders, issuances, and 
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rules  
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SEC 7. Effectivity. – This Act shall take effect immediately following its publication 
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in the Official Gazette or in at least two (2) newspapers of general circulation.  
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Approved,