Republic of the Philippines
HOUSE OF REPRESENTATIVES
Queson City

EIGHTEENTH CONGRESS
Second Regular Session

House BILL Noo352

Introduced by HON. LUIS RAYMUND “LRAY” F. VILLAFUERTE, JR.

AN ACT
PROTECTING CERTAIN TYPES OF MEDICAL COMMUNICATIONS
BETWEEN A HEALTH CARE PROVIDER AND A PATIENT

The offering and operation of health plans is a growing and profitable industry in the
Philippines. Many organizations are either engaged in this business or subscribe to one.
People subscribe to these health plans and pay substantial sums for guaranteed access
to quality health care when they need it.

One of the critical factors that ensure quality health care is a patient's access to all
relevant information necessary to make appropriate decisions about their health care.
Open medical communication between health care providers and their patients is a key
to prevention and early diagnosis and treatment, as well as to informed consent and
quality, cost-effective care, therefore open medical communications are in the best
interests of patients. It is critical that health care providers continue to exercise their
best medical, ethical, and moral judgment in advising patients without interference from
health plans.

This bill seeks to establish a national standard that protects medical communications
between health care providers and patients.

LUIS R, ID “LRAY’7 F} VILLAFUERTE, JR.


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

EIGHTEENTH CONGRESS
Second Regular Session

HOUSE BILL NO. 8352

Introduced by HON. LUIS RAYMUND “LRAY” F. VILLAFUERTE, JR.

AN ACT
PROTECTING CERTAIN TYPES OF MEDICAL COMMUNICATIONS
BETWEEN AHEALTH CARE PROVIDER AND A PATIENT

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 “Patient's Right to Know Act.”
SECTION 2. Definitions of Terms. — For the purposes of this Act, the term:

(A) “Health Care Provider” means anyone licensed or certified under Philippine law to
provide health care services and who is operating within the scope of such license;

(8) “Health insurance issuer” means any company, corporation, association or
organization that offers any policy, contract or agreement that stipulates to provide
for the insured either medical attention, medicine, care during disability, or money
necessary for any such purposes;

(C) “Health plan” means a group health plan and any individual health insurance
operated by a health insurance and includes any other health care coverage
provided through a private or public entity. In the case of a health plan, that is an
employee welfare benefit plan, any third party administrator or other person with
responsibility for contracts with health care providers under the plan shall be
considered, for purposes of enforcement under this section, to be a health issuer
operating such health plan; and

(D) “Medical communication” means any communication made by a health care
provider with a patient of the health care provider or the guardian or legal
representative of such patient with respect to —

(1) The patient's health status, medical care, or legal treatment options;


(2) Any utilization review requirements that may affect treatment options for the
patient; or
(3) Any financial incentives that may affect the treatment of the patient.

The term does not include a communication by a health care provider with a patient of
the health care provider or the guardian or legal representative of such patient if the
communication involves a knowing or willful misrepresentation by such provider.

SECTION 3. Prohibition of Interference with Certain Medical Communications. —
(A) Prohibition. -

(1) General Rule. — The provisions of any contract or agreement, or the
operation of any contract or agreement, between an entity operating a health plan
(including any partnership, association, or other organization that enters into or
administers such a contract or agreement) and a health care provider (or group of
health care providers) shall not prohibit or restrict the provider from engaging in
medical communications with his or her patient.

(2) Nullification. — Any contract provision or agreement described in paragraph (1)
shall be null and void.

(3) Prohibition on Provisions. — Effective on the date described in Section 7, a
contract or agreement described in paragraph (1) shall not include a provision that
violates paragraph (1).

(B) Rules of Construction. — Nothing is this Act shall be construed —

(1) To prohibit the enforcement, as part of a contract or agreement to which a
health care provider is a party, of any mutually agreed upon terms and conditions,
including terms and conditions requiring a health care provider to participate in, and
cooperate with, all programs, policies, and procedures developed or operated by a
health plan to assure, review, or improve the quality and effective utilization of health
care services, if such utilization is according to the guidelines or protocols that are
based on clinical or scientific evidence and the professional judgment of the provide,
but only if the guidelines or protocols under such utilization do not prohibit or restrict
medical communications between providers and their patients; or

(2) To permit a health care provider to misrepresent the scope of benefits
covered under a health plan or to otherwise require the plan to reimburse providers
for benefits not covered under the plan.

SECTION 4. Penalty Clause. — An entity operating a health plan in the Philippines that
Violates Section 3(A) shall be subject to a fine of up to Two Hundred Thousand Pesos
(P200,000.00) for each such violation.


SECTION 5. Separability Clause. — If any provision or part hereof, is held invalid or
unconstitutional, the remainder of the law or the provision not otherwise affected shall
remain valid and subsisting.

SECTION 6. Repealing Clause. —Any law, presidential decree or issuance, executive
order, letter of instruction, administrative order, rule or regulation contrary to or
inconsistent with, the provision of this Act is hereby repealed, modified or amended
accordingly,

SECTION 7. Effectivity Clause. - This Act shall take effect fifteen (15) days after its
publication in at least two (2) newspapers of general circulation.

Approved,