Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

EIGHTEENTH CONGRESS
First Regular Session

HOUSE BILL NO.5121 _

Introduced by Representative Ferdinand L.
Hernandez

AN ACT PROVIDING FOR STANDARDS FOR THE PRACTICE OF
REHABILITATION MEDICINE AND FOR OTHER PURPOSES

EXPLANATORY NOTE

Physical & Rehabilitation Medicine, also known as Physiatry , is a branch of
medicine that aims to restore the functional ability of those with physical
impairments, disabilities and handicaps in order to enhance their quality of life. The
specialty has experienced tremendous growth over the past several years, as seen in
the rise of the number of graduates and medical professionals practicing the said
discipline.

Physical and Rehabilitation Medicine centers are also fast increasing throughout the
country, with the noble intent to deliver expert and comprehensive rehabilitative
care to each patient's unique needs. In order to become effective in providing safe
and patient-centered treatment plans, these centers must be headed by a Physical
and Rehabilitation Medicine Specialist who has completed a minimum of three (3)
years of training in Physical & Rehabilitation Medicine having a broad range of
knowledge in musculoskeletal, neurological, rheumatological, and cardiovascular
systems that will aid them in evaluating and treating patients from various age
groups. Also, they are capable of collaborating with other allied medical professional


and other integral members of the rehabilitative care team, including but not limited
to physical therapists, occupational therapists, speech therapists, orthotists and
prosthetists.

Also, it is vital that these facilities are furnished with the right equipment and
medical tools in order to make accurate diagnosis and implement a specific
treatment plan to help the patients restore their physical mobility and function and
eventually maximize their independence in their daily activities.

This proposed Physical & Rehabilitation Medicine Standard Act seeks to set
standards for the training and practice of Rehabilitation Medicine. Furthermore, it is
also the objective of the bill to set technical and operational guidelines for the
rehabilitation facilities and medical professionals to ensure that the highest quality of
service will be provided to the patients, thereby protecting the interests of those who
seek treatment from these centers.

In view of the foregoing, the immediate passing of this bill is earnestly sought.



Republic of the Philippines
HOUSE OF REPRESENTATIVES,
Quezon City, Metro Manila

EIGHTEENTH CONGRESS
First Regular Session

House BiLt No._5121

Introduced by Representative Ferdinand L.
Hernandez

AN ACT PROVIDING FOR STANDARDS FOR THE PRACTICE OF
REHABILITATION MEDICINE AND FOR OTHER PURPOSES

Be in 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 "Medical Rehabilitation
Standards Act of 2019"

SEC. 2. Declaration of Policy. - It is the policy of the State to protect and promote
the right to health of the people through optimizing function by making the delivery
of expert rehabilitative care to Filipinos suffering from neuromusculoskeletal,
cardiovascular, pulmonary and other system disorders which produce temporary or
permanent disability accessible, effective and affordable. Toward this end, standards
for the effective practice of Rehabilitation Medicine and for the establishment,
management and operations of rehabilitation facilities are hereby established.

‘SEC. 3. - Definitions. - As used in this Act, the following terms shall mean:
Physical & Rehabilitation Medicine - the branch of medicine which deals with the


prevention, diagnosis, treatment and rehabilitation of neuromusculoskeletal,
cardiovascular, pulmonary and other system disorders which produce temporary or
permanent disability in patients as well as the performance of different diagnostic
and therapeutic procedures, including, but not limited to medical prescription,
procedures, injections, drug administration, prognostication, manual therapy,
assessment and review of interventions, neuropsychology, nutrition, provision of
‘equipment and assistive devices, physical modalities, electromyography,
musculoskeletal sonology, manual therapy, therapeutic exercises, prosthetics and
orthotics. It also involves specialized medical care and training of patients with loss of
function so that he or she may obtain his or her maximum potential, physically,
psychologically, socially and vocationally, providing special attention and care to
prevent complications or deterioration, and to assist in physiologic adaptation of
disability, impairment or handicap. In addition, the practice of Physical &
Rehabilitation Medicine uses agents such as heat, light, water, electricity, therapeutic
exercise and mechanical agents in its treatment armamentarium.

a Medical Rehabilitation - the process of helping a person achieve his fullest
physical, psychological, social, vocational, educational and functional potential
consistent with his or her physiologic or anatomic impairments, environmental
limitations and life plans.

b Physical & Rehabilitation Medicine Specialist - a physician who is licensed and
duly registered with the Professional Regulation Commission and who completed
three (3) years of residency training in Physical & Rehabilitation Medicine in a
training institution accredited by the Philippine Academy of Rehabilitation Medicine
Specialty Board.

¢ Philippine Academy of Rehabilitation Medicine (PARM) - a non-stock, non- profit
corporation, duly recognized by the Professional Regulation Commission and the
Accredited Professional Organization (APO) composed of Board Certified Physical
& Rehabilitation Medicine Specialists.

d Philippine Academy of Rehabilitation Medicine Specialty Board (PARM SB) ~ is
the recognized Specialty Board by Philippine Academy of Rehabilitation Medicine
tasked with examining and certifiying competent specialty practitioners.

e Physiatrist — synonym for Physical & Rehabilitation

Medicine Specialist They shall be qualified by the PARM SB as:

A) Board Eligible Physical & Rehabilitation Medicine Specialist - refers to one who
completed residency training in a residency training program accredited by the
PARM Specialty Board but who has not successfully completed the PARM Specialty


Board examination.

8) Board Certified (Diplomate) - refers to those have passed Part I (written) and Part
II (oral) of the Diplomate Board Examination given by the PARM Specialty Board
examination.

f. Physical & Rehabilitation Medicine Center/Facility/Unit - any facility that
renders services for the rehabilitation of physical disabilities and which may be
hospital-based or free-standing.

g. Physical & Rehabilitation Medicine Team - a group of medical and allied health
professionals concerned with the medical rehabilitation of patients with physical
disabilities. The team is composed of, but not limited to, the following:

1. Physical & Rehabilitation Medicine Specialists
2. Physical Therapists

3. Occupational Therapists

4. Prosthetists and Orthotists

5. Rehabilitation Nurses

6. Speech Pathologists

7. Social Workers

8. Vocational Counselors

9. Recreational Therapists

10. Electromyographer

11, Musculoskeletal Sonographer

12. Certified Strength & Conditioning Coach
13. SPED Teachers

14. Neuropsychologist

15. Physical Therapy Aide

SEC. 4. Scope of Practice. - The practice of Physical & Rehabilitation Medicine
includes:

a. Professional services related to the care of an individual patient, rendered in
the role of a physician primarily responsible for individual patient care or as a


consultant to another physician, and consists of

1. History taking, examination of patients, performance of specific diagnostic
procedures for the purpose of establishing diagnosis and evaluation of disability,
impairment, functional capacity and potential for rehabilitation;

2. Prescription and rendering of appropriate medical treatment which may
include any or all, aspects or physical medicine as well as rehabilitative measures,
including but not limited to physical therapy, occupational therapy, speech therapy
and orthotic and prostheticservices.

3. Follow-up examination of patients in offices, hospitals, rehabilitation
facilities, extended care facilities or home for purposes of re-evaluation and
treatment modifications;

4. Appropriate consultation with other medical specialists;

5. Counseling and conference with non-physician health care professionals or
family members concerning conduct of patient's care or patient's progress: and

6 Examination of patient's records, preparation of reports, designing, planning,
and implementation of health programs for the maintenance of health and
prevention of disability; and correspondence as well as appearance in court or
providing testimony pertaining to a patient

b. Professional services related to the administration of rehabilitation
facilities or units consist of:

1. Professional general supervision of rehabilitation services in a hospital-based
rehabilitation center or unit or any other freestanding units that render limited
rehabilitation services, convalescent home and private homes, for quality assurance
and appropriate utilization of services;

2. Planning, establishment and management of facilities, equipment and personnel
for the performance of functions and activities of a rehabilitation department or unit,
or any other free standing unit that render limited rehabilitation services.

Convalescent home and private homes, for quality assurance and appropriate
utilization of services;

3. Maintenance of complete and accurate records and statistics:

4, Education of physicians and allied health care professionals in Rehabilitation
Medicine, both local and foreign, for programs related to Physical & Rehabilitation


Medicine;
5. Education of the public on health care issues pertaining to Rehabilitation Medicine
through research and medical education;

6. Promoting professional development of Rehabilitation Medicine through research
and medical education;

7. Designing, planning and implementing health programs for maintenance of
health and prevention of disability;

8. Establishing linkages with government and non-government agencies, both local
and foreign, for programs related to Rehabilitation Medicine;

9. Promotion of the team approach among medical and allied medical health care
professionals in the holistic care of patients; and

10. Setting standards for compensation of Physical & Rehabilitation Medicine services.

c. Guidelines for Practice in a Physical & Rehabilitation Medicine Facility:

1. Every patient shall be examined and diagnosed by a Physical & Rehabilitation
Medicine specialist . The Physical & Rehabilitation Medicine specialist recommends
an individual treatment plan in collaboration with the Physical & Rehabilitation
Medicine Team. The treatment plan and rehabilitation program shall be regularly
reviewed on a team basis.

2. Medications and various other forms of treatment shall be prescribed by a
physical & rehabilitation medicine specialist.

3. The physical & rehabilitation medicine specialist has the primary responsibility of
regularly following-up on patients in his charge and modifying, or terminating
treatment.

4, A Physical & Rehabilitation Medicine Specialist shall head facility or unit and
collaborate with the physical & rehabilitation team in the delivery of rehabilitation
medicine services.

5. The Physical & Rehabilitation Medicine Specialist shall conduct himself in a
manner consistent with the Code of Ethics of the Accredited Professional
Organization (APO)

SEC. 5. Qualifications to Practice. - A physician who is a Board Certified/Board
Eligible Physical & Rehabilitation Medicine Specialists, of good moral character and
is a member of the Accredited Professional Organization is qualified to practice


Physical & Rehabilitation Medicine.

SEC. 6. Accreditation and Certification. - This Act aims to establish the standards for
the practice of Physical & Rehabilitation Medicine and the certification of Physical &
Rehabilitation Medicine Specialists in order to ensure the highest quality of
professional medical rehabilitation service to the public and to the medical
community.

a. Accreditation of the Physical & Rehabilitation Medicine Specialist.

A Physical & Rehabilitation Medicine Specialist eligible for accreditation is a
graduate of a residency training institution accredited by the Philippine Academy of
Rehabilitation Medicine Specialty Board and recognized by the Accredited
Professional Organization.

SEC. 7. Regulatory Authority - Technical Standards and Requirements for the
Registration, Operation and Maintenance of Rehabilitation Medicine Facilities shall
be implemented and regulated by the Department of Health (DOH) Health Facilities
and Services Regulatory Bureau.

SEC. 8. Management and Operation of a Rehabilitation Medicine Facility. - A
Physical & Rehabilitation Medicine Facility shall be headed by a Physical &
Rehabilitation Medicine specialist who is either a PARM Specialty Board Certified or
Eligible Physical Rehabilitation Medicine specialist in the said facility.

SEC. 9. Classification of Facilities - Rehabilitation Medicine facilities shall be
classified according to the institutional character, and extent of services offered. The
bases for the classification of the different categories of Rehabilitation facilities are:
(1) Physical and Rehabilitation Medicine Specialist qualification, (2) Allied Health
personnel staff qualification, (3) Physical and Rehabilitation Medicine services
available and (4) Physical set-up and equipment.

a. Categories

1. _ As to institutional character, a Physical and Rehabilitation Medicine facilities
are either hospital-based (if operating within a hospital set-up) or freestanding (if
operating on its own or part of a facility other than a hospital).

2. As to the extent of services, a Physical and Rehabilitation Medicine facilities
maybe primary, secondary ,

tertiary, or home-based.

3. As to function, a Physical and Rehabilitation Medicine facility may be utilized for
training services and research or for services alone.


4, As to services, a rehabilitation Medicine facility can also be either general or
specialized.

b. A primary rehabilitation Medicine facility shall have the following:

1. At least one (1) PARM Specialty Board eligible physiatrist;

2. At least one (1) allied rehabilitation health professional;

3. Physical & Rehabilitation Medicine consultation and management with
physical therapy services;

4, Physical set-up;

5. Medical consultation area;
6. Treatment area to include at least an electrotherapy device and superficial heating

modality, and activities of daily living (ADL) training devices;

7. Gym area, to include parallel bars, mirror, weights and assistive devices such as
canes, crutches, and walkers among others;

8. Evaluation tools;

9. Adequate utilities such as water, electricity and consumables; and
10. First Aid kit with basic CPR equipment

c. A secondary Rehabilitation Medicine facility shall have the following:
1. At least one (1) PARM Specialty Board certified Physiatrist;

2. At least one (1) licensed therapist and occupational therapist;

3. Rehabilitation Medicine consultation and management, physical and occupational
therapy services; and

4, Compliance with the primary category set-up plus deep heating modality, manual
traction and therapeutic exercise equipment for the gym area.

d.A tertiary Rehabilitation Medicine facility shall have the following:

1. Atleast one (1) PARM Specialty Board certified Physical & Rehabilitation Medicine
Specialist

2. At least one (1) licensed physical therapist and occupational therapist;

3. Physical & Rehabilitation Medicine consultation and management, physical
therapy, occupational therapy, speech therapy; prosthetics and orthotics in-house or


referral services.

4, Compliance with the secondary category set-up and equipment, with additional
two (2) superficial heating modalities, medium frequency modality, ultraviolet or
cold laser intermittent compression unit, mechanized intermittent traction and tilt
table with additional gym equipment.

5. A Training/Service and Research facility, which shall fulfill all the requirements as
a residency training institution in accordance with PARM SB guidelines.

6.A_ specialized facility which should cater to subspecialty conditions in
rehabilitation medicine including cardiac, pain, pediatric, pulmonary, sports, among
others, shall be a hospital-based facility with a multidisciplinary set-up.

SEC. 10. Management and Operation of a Rehabilitation Medicine Facility. - A
Physical and Rehabilitation Medicine Facility shall be headed by a Physical &
Rehabilitation Medicine specialist who is either a PARM SB Certified or Eligible
Physical and Rehabilitation Medicine specialist in the said facility. An adequate and
effective system of documentation, recording and recordkeeping must be
maintained for all consultations and services in the facility. The rates for consultation
and services shalll be in accordance with the standards of the Accredited Professional
Organization and PhilHealth.

SEC. 11. Application for Registration and Issuance of License. -Applications for
registration and issuance of a license shalll be filed by the owner of the facility or his
duly authorized representative with the Department of Health (DOH) Health
Facilities and Services Regulatory Bureau, together with an information sheet to be
filled up by the Physical and Rehabilitation Medicine Specialist-in-charge. Upon
receipt of the said application together with the license fee, the PARM technical
committee team will inspect the facility within sixty (60) days. Certificates of licenses
shall be issued and approved by the Head of the Department of Health (DOH)
Health Facilities and Services Regulatory Bureau. A provisional license may be
granted to facilities with insufficient requirements for special cases for a period of
‘one (1) year.

SEC. 12. Terms and Validity of License. — The license to operate valid for a period of
two (2) years. Application for renewal of the license shall be made during the last six
(6) months of validity. The license must be placed in a conspicuous place within the
facility. A copy of the rules and regulations should also be readily available. In any
violation of the standards provided, the license to operate may be revoked.
Investigation of all charges or complaints against a Physical and Rehabilitation
Medicine facility or any of its personnel shall be made to the Accredited Professional

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Organization (when complaint is against the Physical & Rehabilitation Medicine
Specialist) and to the Department of Health (DOH) Health Facilities and Services
Regulatory Bureau for appropriate investigation.

SEC. 13. Penalties. - Any person, partnership, association, or corporation who
establishes, operates, conducts, manages or maintain a rehabilitation medicine facility
within the meaning of this Act without first obtaining a license or violates any
provision of this Act or its Implementing Rules and Regulations shall be liable to fine
of not less than Forty Thousand Pesos (Php 40,000.00) but not to exceed One Hundred
Thousand Pesos (Php 100,000.00) for the first offense, and not less than One
Hundred Thousand Pesos (Php 100,000.00) but not to exceed One Hundred
Thousand Pesos (Php 100,000.00) for the second offense, and not less than Two
Hundred Thousand Pesos (Php 200,000.00) but not to exceed Four Hundred
Thousand Pesos (Php 400,000.00) for the third and each subsequent offense. Each
day that a facility or other related facility shall operate after the first violation shall be
considered a subsequent offense. In addition to the penalties specified in the
preceding paragraph, the Department of Health (DOH) Health Facilities and
Services Regulatory Bureau, upon the approval of the Secretary of Health, may
summarily order the closure of any rehabilitation medicine facility found without a
license.

SEC. 14. Implementing Rules and Regulations (IRR). ~ to implement provisions of
this Act, The Department of Health (DOH) Health Facilities and Services Regulatory
Bureau , in coordination with the national professional organization duly recognized
by the Professional Regulation Commission, shall promulgate the rules and
regulations, including the technical standards and requirements for the registration,
operation and maintenance of the rehabilitation medicine facilities, within ninety
(90) days after the effectivity of this Act.

SEC. 15. Separability Clause. - if any part or provision of the Act shall be held
unconstitutional or invalid, other Provisions hereof which are not affected hereby
shall continue to be in full force and effect.

SEC. 16. Repealing Clause. — All laws, decrees, rules and regulation inconsistent
with the provision of this Act hereby repealed or modified accordingly.

SEC. 17. Effectivity. — This shall take effect after fifteen (15) days from its publication
in two (2) national newspaper of the general circulation.

Approved.

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