Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City
1 9th CONGRESS
Second Regular Session
HousEBILLNo.     10279
RECEIVED
DATE  ^PR   2  9  20
I, fa T_I_ap.I+#
Introduced by HONORABLE IVIILAGROS AQUINO-IVIAGSAYSAY
AN ACT PROVIDING FOR FREE HEMODIALYSIS, PERITONEAL DIALYSIS,
AND OTHER DEPARTMENT OF HEALTH-APPROVED DIALYSIS PROCEDURES T0
FILIPIN0 SENIOR CITIZENS
EXPLANATORY NOTE
This  bill  seeks  to  provide  for  free  hemodialysis,  peritoneal  dialysis,  and  other  similar
essential  dialysis  procedures  approved  by the  Department of Health  (DOH)  for Filipino  senior
citizens.
Chronic Kidney Disease (CKD) continues to be a major health concern which affects an
estimated one on every ten persons. Although usually considered a comorbidity of diabetes and
hypertension, kidney disease has numerous complex causes. It has been shown that the elderly,
especially those senior citizens from 65 to 74 years old are prone to CKD, with one in every five
men, and one in every four women affected. This susceptibility places senior citizens at a higher
risk of serious complications and death from heart attacks and strokes.
The  Global  Burden  of Disease  Study of 2015 estimated  1.2M  people died  from  kidney
disease, a 32% increase from 2005. The 2017 Global Burden of Disease Study conducted by the
Institute for Health Metrics and Evaluation (lHME) emphasized the continuing considerable impact
of CKD on mortality and morbidity rates around the world. The World Health Organization (WHO)
itself estimates 5 to 10 million people die annually from kidney disease.
In  the  Philippines,   kidney  disease,  especially  End-Stage  Renal  Disease  (ESRD),   is
already the 7th  leading  cause  of death  among  Filipinos.  According to the National  Kidney  and
Transplant  Institute  (NKTl),120  Filipinos  per million  population  per year develop  chronic  renal
failure. The Philippines is said to have experienced a large rise in the prevalence of dialysis with
an approximate increase of 400% over the past 10 years. At present,  more than 5,000 Filipino
patients are undergoing dialysis and an approximately 1.1  million people worldwide are on renal
replacement therapy.
Thus, access to proper treatments like hemodialysis, peritoneal dialysis, and other dialysis
procedures may mitigate the suffering and adverse effects of CKD, although at a significant cost.
Previously, under PHILHEALTH Ciroular No. 22-2015, only covered 90 of the 144 needed dialysis


sessions, leaving the remaining 54 sessions in the amount of around P135,000.00 to be borne by
the patient. With the passage of Republic Act (RA) No. 11223, otherwise known as the "Universal
Health  Care  (UHC)  Act",  it  is  now  provided  that  a  portion  of  the  funds  from  the  P.hilippine
Amusement and  Gaming  Corporation  (PAGCOR)  income and  Philippine Charity Sweepstakes
Office (PCSO) charity fund shall be transferred to PHILHEALTH for the improvement of benefits
packages,  including  the  hemodialysis  benefits  package.  PHILHEALTH  Board  Resolution  No.
2776,  Series  of  2023  further  expanded  the  hemodialysis  benefit  package  to  cover  156  HD
sessions per year, or 52 weeks of 3x a week HD sessions.
Considering   the   reality  that   many   senior  citizens   are   already   undergoing   dialysis
procedures,  and the  inevitability  of many  Filipino  elderiy  developing  CKD which  will  eventually
require  costly  dialysis  sessions,  this  bill  seeks  to  institutionalize  and  further  formalize  such
expanded  benefit  packages  under PHILHEALTH,  specifically for dialysis treatments for senior
citizens.
In view Of the foregoing, the passage of this bill is earnestly recommended.


Republic of the Philippines
House of Representatives
Quezon City,  Metro Manila
Nineteenth Congress
Second Regular Session
HousE BiLL No.1G27. 9
Introduced by Representative Milagros AquinolMagsaysay
AN ACT PROVIDING  FOR FREE  HEMODIALYSIS,  PERITONEAL DIALYSIS,
AND OTHER DEPARTMENT OF HEALTH-APPROVED DIALYSIS PROCEDURES TO
FILIPINO  SENIOR CITIZENS
Be it enacted  by the Senate and the House of Representatives of the Philippines in Congress
Assembled
SECTION  1. Short Title -This Act shall be known as the "Free D/.a/ys/.s for Seni'ors Act of
2024„.
SECTION  2.  Declaration  of Policy -lt shall  be the declared  policy  of the  State to  protect and
promote  the welfare  and  interest  of  Filipino  senior  citizens,  and  ensure  a  decent  and  dignified
standard of living  and quality of life by providing accessible programs and affordable services.
Under the 1987 Constitution, Article Xlll, Section 11, the State is mandated to "ac/apt an t.nfegrated
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 pr.Iority for the needs of the underprivileged, sick, elderly, disabled, women, and children.
The  State  shall  endeavor  to  provide free  medical  care  to  paupers."  ln  add.Ttiion,  ATtlale  11,
Section X declares.. "The State shall promote social justice in all phases of national development."
Moreover , A`rtlcle XW , Sechion IV prov.ides.. " The family has the duty to care for its elderly members,
bLit the State may also do so through just programs of social security."
SECTION  3.  Definition of Terms -As used in this Act, the following terms shall mean:
a.  "Chronic Kidney Disease Stage 5 (CKD5)" -refers to end-stage renal disease (ESRD) or an
advanced stage of kidney disease resulting to irreversible loss of nearly all ability to remove toxic
by-products from the blood.
b.  "Hemodialysis (HD)" -refers to medical procedure of removing fluid and waste products from
the   blood,   and   correcting   electrolyte   imbalances.   This   is   accomplished   using   a   synthetic
membrane  or dialyzer,  which  is  also  referred to as an  "artificial  kidney".


c. "Philippine Dialysis Database (PDD)" - refers to a system that collects data on members
and dependents with CKD5 (previously known as End-Stage Renal Disease (ESRD)), who are
presoribed HD, peritoneal dialysis, or kidney transplantation (KT).
SECTION 4.  Free Dialysis Sessions for Filipino Senior Citizens - The cost of the needed
hemodialysis,   peritoneal   dialysis,   and   other   DOH-approved   dialysis   procedure   shall   be
reimbursed  by  the  Philippine  Health  Insurance  Corporation  (PHILHEALTH),   provided  such
treatment  is  availed  of at  PHILHEALTH-accredited  hospitals  or free-standing  dialysis  centers.
Provided further, that only those procedures that use the dialysis solutions included in the latest
edition   of   the   Philippine   National   Drug   Formulary   (PNDF)   shall   be   reimbursed   by   the
PHILHEALTH.   Provided   finally,   that   only   laboratory   procedures   and   supplies   considered
necessary  shall  be  covered  by  the  PHILHEALTH.   PHILHEALTH  shall  as  soon  as  possible
reimburse all official receipts for drugs, supplies, and laboratory procedures dated thirty (30) days
prior to the date of the claimed session.
SECTION 5. Manner of Availment -  Pursuant to PHILHEALTH Circular No. 2023-0009, the free
dialysis for free senior citizens shall be availed of under the following terms:
a.    Senior citizen patients with CKD5 on dialysis treatment shall be allowed up to a maximum
of 156 treatment sessions per year based on the prescription of their nephrologist;
b.   All  senior  citizen  patients  diagnosed  with  CKD5  shall  be  registered   in  the  PDD  in
accordance with PC No. 2016-0007, or "PhilHealth Dialysis Database (POD)";
c.    The package rate for HD treatment is P2,600/session, divided between health facility (HF)
and professional, as follows:
Package Rate:                                        HD Fee
P2,600.00                                                  P2,250.00
Professional Fee
P350.cO
d.   The  benefits  package  includes  the  use  of facility  and  dialysis  machine,  PNF  drugs  as
needed, IV solutions, supplies, dialyzer, and professional fees;
e.   The 45-day annual  benefit limit shall  not apply to the  156 HD  benefits package.  In the
event that the CKD5 patient on HD needs hospital confinement, the HD session shall be
filed separately and shall not overlap with the ln-Patient claim;
f.     Unused  HD  treatment  session  of  the  current  year  shall  not  be  carried  over  to  the
succeeding year;
9.    The "No-BalanceBilling (NBB)" Policy, as stipulated under PC No. 2017-0017, shall apply
to healthcare services contemplated under PhilHealth Circ. 2023-0009;
h.   Accredited  health  facility  providing  services  for the  HD  shall  be  subject to  the  current
performance monitoring policy of the PhilHealth;
i.     Accredited   health  facility  shall   comply  with   all  the  provisions   in  their  Performance
Commitment and other rules and regulations governing PhilHealth accreditation;
j.     In case of delays in the filing of claims due to natural calamity or other fortuitous events,
the existing guidelines of PhilHealth on  providing special  privileges to those affected  by
fortuitous events shall apply;
k.    In  order to  educate  the  general  public  and  increase  their  awareness  of this  benefits
package  and  to  promote  informed  decision-making  and  participation  among  elderly


patients, healthcare professionals, and health facilities, and other stakeholders, marketing
and  promotional  activities  shall  be  undertaken  following  the  integrated  marketing  and
communications plan of PhilHealth;
I.     The monitoring of benefits delivery and  performance of health facility shall  be anchored
on  PhilHealth's  monitoring  framework.   Random  post-audits  shall  be  conducted  upon
implementation of PhilHealth Circ. 2023-0009 to monitor, evaluate, and revise this policy,
as necessary; and
in.   In consultation and collaboration with relevant stakeholders,  experts and technical staff,
the PhilHealth shall conduct the policy review of this benefits package as necessary, and
recommend further enhancements for better implementation  and optimum availment of
senior citizens.
SECTION  6. Appropriation - The amount  needed for the implementation  of this Act shall  be
charged to the current year's appropriations of the DOH and the PHILHEALTH, in the current and
subsequent General Appropriations Act and their own respective funds.  Thereafter, such amount
as may be necessary for the continued implementation of this Act shall be included in the annual
General Appropriations Act.
This is without prejudice to the portion of funds that PHILHEALTH may continue to receive from
the  Philippine  Amusement  and  Gaming  Corporation  (PAGCOR)  and  the  Philippine  Charity
Sweepstakes Office (PCSO) for further improvement of existing benefit packages, programs or
services under PHILHEALH.
SECTION 7. Implementing Rules and Regulations- Vvithin ninety (90) days or three (3) months
from  the  approval  of this  Act,  the  DOH,  PHILHEALTH,  the  National  Commission  on  Senior
Citizens  (NCSC),  in  coordination  with  other  relevant  implementing  agencies  and  concerned
stakeholders, shall formulate and promukyate the rules and regulations necessary for the effective
implementation of this Act.
SECTloN 8. Separability clause - lf any portion or provision of this Act is declared invalid or
unconstitutional, other provisions not affected thereby shall continue to be in full force and effect.
SECTION  9.  Repealing  clause  -  All  laws,  decrees,  executive  orders,  rules  or  regulations
contrary  to  or  inconsistent  with  the  provisions  of  this  Act  are  hereby  repealed  or  modified
accordingly.
SECTION  10.  Effectivify -This Act shall  take effect fifteen  (15)  days  after  publication  in  the
Official Gazette or in newspaper of general circulation.
Approved