HOUSEOF REPRESENTATIVES |

RECEIVE)
ES ue 2016
DATE:

Republic of the Philipines tive. Suc oa
HOUSE OF REPRESEN’ TIVES. —
Quezon City =

UNT
SERVICE

SEVENTEENTH CON
First Regular Session

gGRECISTRAT
Bits AND Ui

HOUSE BILL NO. 3085

Introduced by Rep. Winston “Winnie” Castelo

EXPLANATORY NOTE

While there is a prevailing scheme of accreditation as would govern the
administration and operation of health maintenance organizations, it is only to the
extent that a ‘Clearance to Operate’ is issued by, at present, the Department of
Health, specifically, the Office for Health Facilities Standards and Regulations.

Health management organizations are akin to business entities that arrange for pre-
paid health care services for their members by contracting with hospitals, physicians
and other health professionals for their services.

The members who are provided with medical services are those duly enrolled with
these HMOs who may be as out-patient or in-patient. However, there are instances
that bona fide cardholders do not get to avail of their maximum benefits that they
should otherwise enjoy by way of exemptions.

To this end, there must be a regulatory commission to take charge of multi-faceted
problems that now plague this industry as the ones that serve as medical services
providers in the broad sense of the term.

The commission so created shall be able to address various hyfniliating experience
of patients that could have otherwise been remedied or fully/addressed since in the
absence of such regulatory body, these problems will cgntinue to permeate this
health concern by an increasing number of current or prosyective enrollees.


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SEVENTEENTH CONGRESS
First Regular Session

HOUSE BILL No.8085

Introduced by Rep. Winston “Winnie” Castelo

AN ACT
CREATING THE HEALTH MANAGEMENT ORGANIZATIONS REGULATORY
COMMISSION AND APPROPRIATING FUNDS THEREFOR AND FOR OTHER
PURPOSES

Be it enacted in the Senate and the House of Representatives of the Republic of the
Philippines in Congress assembled:

SECTION 1: This Act shall be known as the “Health Management
Organizations Regulatory Commission of 2016.”

SEC. 2. There is hereby created this independent Health Management
Organizations Regulatory Commission.

SEC. 3. For purposes of this Act, the Commission shall provisionally adopt its
mandate, control supervision and authority over all health management
organizations from the hitherto existing Office for Health Facilities Standards and
Regulations and the Rules and Regulations on the Supervision of Health
Maintenance Organizations as set forth pursuant to Administrative Order No. 34 of
the Department of Health;

Provided, that after two years of transition in the administration and operation
of all health management organizations throughout the country, said Commission
shall automatically evolve as independent in its overall administrative and operations
functions as the proper regulatory agency.

SEC. 4. Thenceforth, the Health Management Organizations Regulatory
Commission shall issue new set of supervisory and regulatory guidelines, rules and
regulations to effectively implement the provisions of this Act.

SEC. 5. All laws, decrees, issuances, executive orders, rules and regulations
inconsistent with the provision of this Act are hereby repealed or modified
accordingly.

SEC. 6. This Act shall take effect upon its publication in the Official Gazette
and in at least three newspapers of general circulation thirty (30) days upon its
approval.

Approved,