EIGHTEENTH CONGRESS OF THE ) ff, RECEIVE Dp”

REPUBLIC OF THE PHILIPPINES ) i
First Regular Session ) .. AUG 06 2019 “"}
HOUSE OF REPRESENTATIVES
H.5.No. 2486

INTRODUCED BY REPRESENTATIVE FERDINAND L. HERNANDEZ

AN ACT
INSTITUTIONALIZING MALASAKIT CENTERS TO COMPLEMENT THE
IMPLEMENTATION OF REPUBLIC ACT NO. 11223 OTHERWISE KNOWN AS THE
“UNIVERSAL HEALTH CARE ACT” BY REQUIRING PHILHEALTH TO ESTABLISH,
OPERATE AND MAINTAIN MALASAKIT CENTERS IN ALL DOH, LGU, SUC and
DND HOSPITALS IN THE COUNTRY, PROVIDING FUNDS THEREFOR, AND FOR
OTHER PURPOSES

EXPLANATORY NOTE

Healthcare should be accessible for all Filipinos. At present, however, it is not
uncommon for indigent patients or their relatives to knock on the doors of various
government agencies to avail of financial assistance to help cover for their medical expenses.
However, a number of indigent Filipinos, specifically those living in far-flung provinces and
do not have the financial means to travel and personally request for medical assistance,
cannot readily avail of the help that these agencies provide.

On 20 February 2019, Republic Act (R.A.) No. 11223, otherwise known as the
“Universal Health Care Act,” was enacted and every Filipino citizen was automatically
included into National Health Insurance Program.

The benefits of R.A. No. 11223 rely on health benefits package as determined by the
Philippine Health Insurance Corporation (PhilHealth), and indigent Filipinos may still incur
expenditures if the benefit packages are not enough to cover their medical needs.
Furthermore, the challenge remains in how the benefits under R.A. No. 11223, as well as


those provided by various government agencies, may be made readily available for the
benefit of every Filipino, especially in favor of our indigent citizens.

In 2018, a one-stop shop called the “Malasakit Center” was launched by the
‘government in the Vicente Sotto Memorial Medical Center in Cebu City. Seen as an effective
measure that eased the process of availing government services for indigent patients, more
Masakit Centers were established. By the first half of 2019, there were about thirty four (34)
Malasakit Centers all over the country.

This proposed legislation, which is authored by Senator Christopher “Bong” Go in
the Senate, intends to complement R.A. No. 11223 by establishing, maintaining, and
operating Malasakit Centers in government-owned and operated hosptials, effectively
introducing an additional means to reduce, if not eliminate, the out-of-pocket expenditures
that may be incurred by indigent Filipinos seeking for medical assistance.

Furthermore, this proposed increase in the number of Malasakit Centers is also
aimed at improving the assessment of the needs of each indigent patient as well as provide
the proper medical referrals so that each patient shall receive proper medical assistance.

In light of the foregoing, the immediate enactment of this proposed legislation is
sought.



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EIGHTEENTH CONGRESS OF THE )

REPUBLIC OF THE PHILIPPINES )
First Regular Session )
HOUSE OF REPR! “ATIVES
mono. 3406

INTRODUCED BY REPRESENTATIVE FERDINAND L. HERNANDEZ

AN ACT
INSTITUTIONALIZING MALASAKIT CENTERS TO COMPLEMENT THE
IMPLEMENTATION OF REPUBLIC ACT NO. 11223 OTHERWISE KNOWN AS THE
“UNIVERSAL HEALTH CARE ACT” BY REQUIRING PHILHEALTH TO ESTABLISH,
OPERATE AND MAINTAIN MALASAKIT CENTERS IN ALL DOH, LGU, SUC and
DND HOSPITALS IN THE COUNTRY, PROVIDING FUNDS THEREFOR, AND FOR
OTHER PURPOSES

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 “Malasakit Centers Act of
2019.”

SEC. 2. Declaration of Policies. - It is the declared policy of the State to improve the
delivery of health care services to the people, and to ensure financial assistance for hospital

and medical expenses are available and accessible to the people.

SEC. 3. Definition of Terms. - For purposes of this Act, the following terms shall
mean:

(a) DOH Hospital refers to a refers to a hospital under the management and
administration of the Department of Health (DOH), including the four (4) corporate
hospitals under the Secretary of Health, namely: Philippine Heart Center, Lung
Center of the Philippines, National Kidney and Transplant Institute and the
Philippine Children's Medical Center;

(b) DND Hospital refers to a hospital managed by the Department of National Defense;


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(©) Financial Assistance or Material Assistance refers to actual cash or check which covers
burial, transportation, and other allied assistance given by agencies as mandated by
existing laws, rules and regulations to provide such assistance;

(d) Indigent Patient refers to patient who has no visible means of income, or whose
income is insufficient for the subsistence of his/her family, as identified by the
Department of Social Welfare and Development (DSWD), LGU social worker or the
‘medical social worker of the health facility;

(e) Local Government Unit (LGU) Hospital refers to a hospital managed by the local
government units, usually the provincial government;

(8) Malasakit Center refers to a processing center for Philhealth and one-stop shop for
Filipinos in need of medical assistance;

(g) Medical Assistance refers to assistance for out-of-pocket expenditure in form of
coupon, stub, guaranty letter, promissory note or voucher that has monetary value,
given directly to individual recipients or beneficiaries to address their immediate
needs;

(h) Out-of-pocket expenditure refers to medical and surgical services not currently paid for
or sufficiently reimbursed by PhilHealth under Republic Act No. 11223 or the
Universal Health Care Act, or other financing sources;

(®) Poor Patient refers to those not classified as indigent but are otherwise considered
poor or with financial difficulty to access adequate medical care and/or pay hospital
bills because of certain unavoidable circumstance, such as but not limited to:

1. Senior citizens, persons with disability (PWD), orphans, abused women and
children as defined by RA 9262 or the Anti-Violence Against Women and Their
Children Act of 2004 and RA 7610 or the Special Protection of Children Against
Abuse, Exploitation and Discrimination Act;

2. Patients with catastrophic iliness or any illness as a primary condition that is life
or limb-threatening and requires prolonged hospitalization, extremely expensive
therapies or other special but essential care that would deplete one’s financial
resources, unless covered by special health funding policies;

3. Unemployed or without gainful employment;

4, Suspected or confirmed victims of torture as defined by Republic Act No.9745 or



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the Anti-Torture Act of2009;

5. Soldiers and police rendered disabled to be gainfully employed and their
dependents and dependents of soldiers and police killed in action;

6. Rebel returnees, prisoners of war and their dependents;

7. Victims of calamities or disasters such as but not limited to typhoons,
earthquake, whose place of residence are officially under a state of emergency or
calamity; and

() SUC Hospital refers to hospitals managed by State Universities and Colleges.

SEC. 4, Malasakit Centers. - To complement the implementation of Republic Act
No. 11223, otherwise known as the Universal Health Care Act, there shall be established a
Malasakit Center in each DOH, LGU, DND and SUC hospital in the country which shall
serve as (a) processing center for all Philhealth concerns regarding coverage, billing, health
benefits packages, patient navigation and referral to the health care provider network, and
(©) one-stop shop medical assistance to cover out-of-pocket medical expenses of indigent
and poor patients.

The Philhealth shall administer and manage the Malasakit Centers in close
coordination with the DOH and DSWD. Each Malasakit Center shall consist of duly
designated representatives from the Philhealth, DOH and DSWD with the following
delegation of functions:

1. The Philhealth representative shall be in charge of the over-all operation of the
Malasakit Center. He/she shall assist and process the concerns of both direct and
indirect contributors to Philhealth regarding the implementation of Republic Act
No. 11223, including but not limited to coverage, billing, health benefits packages,
financial concerns. The Philhealth representative shall also assist in
patient navigation and referral to the health care provider network;

2. The DOH representative shall be in charge of providing medical assistance to
indigent and poor patients; and

3. The DSWD representative shall be in charge of providing financial or direct
assistance to indigent and poor patients.


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SEC 5. Provision of Medical Assistance. — The DOH shall provide medical assistance
to indigent and poor patients through the Malasakit Center which shall be charged from the
annual appropriation of the DOH for assistance to indigent patients. The DOH may also
augment medical assistance using the following sources:

a) Other appropriations earmarked by national government agencies and local
‘government units purposely for medical assistance to indigent and poor patients:
Provided, That appropriations earmarked for a specific hospital shall only be used
for that specific hospital; and

b) Donations and grants-in-aid: Provided, That donations and grants donated for a
specific hospital shall only be used for that specific hospital: Provided further, That
the donations ang grants shall only be used for the purpose specified by the donor.

The DOH shall issue guidelines for the proper implementation of the medical
assistance to indigent and poor patients which shall include order of charging from the
aforementioned sources of financing, availment procedures, transfer and release of funds,
recording and reporting, monitoring and evaluation, partnerships with private hospitals,
among others.

The DOH shall make a quarterly report to the Office of the President and Congress
regarding the expenditures or disbursement of the medical assistance to indigent and poor
patients.

SEC 6. Medical Assistance. - The Medical Assistance shall cover for medical and
surgical services not currently paid for or sufficiently reimbursed by PhilHealth in
accordance with Republic Act No. 11223 or other financing sources, and shall be used for the
following drugs, medicines, goods and other services prescribed by the physician of the
health facility such as but not limited to:

a. Laboratory, imaging and all other diagnostic procedures;

b. Drugs and medicines included in the Philippine National Drug Formulary

(exemptions to be cleared by Pharmaceutical Division);
. Supplies, orthopedic/assistive devices, prosthesis, blood and blood products;


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. Dental services, except those that are for aesthetic purpose and not medically
indicated;

e. All clinically indicated medical and surgical procedures, whether emergency or
elective;

f.Prescribed post-hospitalization rehabilitation services, aftercare program,
appropriate mental and psychological support, including those done on an
outpatient basis;

In case of non-availability of clinically indicated drugs, medicines, tests, services or
procedures in government health facilities, the concerned government health
facility may enter into contract with DOH-accredited private health facility to
provide the needed drug, test, service or procedure to the patient, charged against
the DOH hospital;

h. All hospital bills including professional fees, provided that the expenses for
professional fees shall not exceed fifty percent (50%) of the approved assistance;
and

i. All other medical, health, documentary and related services billed by the hospital.

Provided, That medical assistance to patients shall be based on need as recommended

by the medical social worker attending physician, approved by the Chief of
Hospital/Medical Center Chief of the institution involved and DOH authorized officials,
subject to availability of funds.

SEC. 7. Provision of Financial Assistance. ~ The DSWD shall provide financial
assistance through the Malasakit Center to indigent and poor patients, individuals in
emergency situations, under distress or are in need of supplemental financial support due to
health or medical conditions, sickness or disease; funeral and burial concerns, which also
includes the most direct and economical transportation expense to or from place of
residence or specific destination.

The provision of financial assistance through Malasakit Centers shall be charged to the
annual appropriation of the DSWD for assistance to individuals and families in difficult
circumstances. The DSWD shall issue policies and guidelines on the release of such
assistance for the proper implementation of the program.


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SEC. 8, Establishment of Malasakit Centers. - The Philhealth and DOH shall, in the
establishment of the Malasakit Centers, undertake consultations with all DOH, LGU, DND
and SUC hospitals; Provided, That in the establishment of the Malasakit Centers, highest
priority shall be given to those economically-depressed areas or provinces.

Within three (3) years from the effectivity of this Act, the Philhealth and DOH shall
establish Malasakit Centers down to the Primary and Secondary Care level to help facilitate
the adoption of appropriate health seeking behaviors, assist primary care providers in
encouraging medical consultation at the health centers, monitor patient compliance, and
ensure proper patient referral and availment of benefits.

Private hospitals are hereby encouraged to establish Malasakit Centers. The
Phithealth and DOH may enter into a Memorandum of Agreement with private hospitals
for the establishment of Malasakit Centers which shall cater indigent and poor patients of
the private hospital.

SEC. 9. Donations from Non-Governmental Organizations and the Private Sector. -
The DOH may solicit and receive donations from the private sector for medical assistance to
indigent and poor patients. Such donations shall be exempt from income or donor's tax and
all other taxes, fees and charges imposed by the government: Provided, That donations from
the private sector for a particular hospital shall only be used for the benefit of the patients of
the particular hospital: Provided further, That the donations ang grants shall only be used
for the purpose specified by the donor. As such, the donor may send his or her
representatives to the Malasakit Center for the provision of the medical assistance donated
by the donor in the particular hospital.

Receipts from donations, whether in cash or in kind, shall be accounted for in the
books of the DOH in accordance with accounting and auditing rules and regulations. The
receipts from cash donations and proceeds from sale of donated commodities shall be
deposited with the National Treasury and recorded as a special account in the General Fund
and shall be available to the DOH through a special budget pursuant to Section 35, Chapter


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5, Book VI of Executive Order No. 292. Donations with a term not exceeding one (1) year
shall be treated as trust receipts.

The DOH shall submit the quarterly reports of all donations received, whether in
cash or in kind, and expenditures or disbursements thereon with electronic signature to the
DBM, through the Unified Reporting System, and to the Speaker of the House of
Representatives, the President of the Senate of the Philippines, the House Committee on
Appropriations, the Senate Committee on Finance and the Commission on Audit, by posting
such reports on the DOH website for a period of three (3) years. The head of the DOH shall
send written notice to the said offices when said reports have been posted on its website
which shall be considered the date of submission.

SEC 10. Appropriations. - The amount necessary to establish Malasakit Centers shall
be included in the General Appropriations Act. Additionally, there shall be an annual
appropriation for the assistance to indigent patients under the DOH specifically for medical
assistance to indigent and poor patients as provided for in Section 5 of this Act, and an
annual appropriation for assistance to individuals and families in difficult circumstances
under the DSWD budget for financial assistance to indigent and poor patients as provided
for in Section 7 of this Act.

SEC 11. Implementing Rules and Regulations. - Within ninety (90) days from the
approval of this Act, Philhealth, DOH, DSWD, in coordination with Department of Interior
and Local Government shall jointly issue the implementing rules and regulations of this Act.

SEC. 12. Separability Clause. - Any portion or provision of this Act that is declared
unconstitutional shall not have the effect of nullifying other portions or provisions hereof as
Jong as such remaining portions can still subsist and be given effect in their entirety.

SEC. 13. Repealing Clause. - All laws, ordinances, rules, regulations, other issuances
‘or parts thereof, which are inconsistent with this Act, are hereby repealed or modified
accordingly.


1 SEC. 14. Effectivity. - This Act shall take effect fifteen (15) days after its publication
2 in the Official Gazette or in a newspaper of general circulation.

Approved,