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

TWENTIETH (20'") CONGRESS
FIRST REGULAR SESSION

House Bill No. 760

Introduced by
Rep. ROBERT NAZAL

AN ACT
FOR THE PROVISION OF
MEDICAL ASSISTANCE TO INDIGENT PATIENTS UNDER THE MEDICAL
ASSISTANCE TO INDIGENT PATIENTS (MAIP) PROGRAM AND MANDATING THE
ACCEPTANCE OF LETTERS OF GUARANTEE FROM THE GOVERNMENT AS
PAYMENT FOR MEDICAL OR HOSPITAL BILLS

EXPLANATORY NOTE

One of the key strategies of the Philippine Development Plan 2016-2022 is to cover all
Filipinos against financial health risk. Thus, providing access to medical care for indigent
or financially challenged Filipinos especially in cases of critical illnesses will definitely
save countless lives and improve the overall quality of living of our countrymen and
women.

In this regard, mobilizing, streamlining, and harmonizing access to sources of funds will
help in the provision of financing for the health and medical needs of the Filipino people.
How many Filipinos have perished due to lack of funds to enable access to good medical
care? How many families have suffered and fell into debt due to prolonged hospitalization
that required significant financial resources? Many of our fellow men and women resist
regular medical check-ups and screening because of the expenses associated with
quality medical care.

While the recent pandemic has presented challenges to the public health sector and
underscored the need to increase the capacity of our health facilities and hospitals, we
cannot discount the increasing occurrence of critical illness cases in our country. In fact,
in a report by the Philippine Statistics Authority, Ischaemic heart diseases,


cerebrovascular diseases, and the COVID-19 virus were identified as the leading causes
of death in the Philippines as of 31 January 2022."

In addition to the foregoing, it is also a known fact that the economy is just recovering
from the adverse impact of the COVID-19 pandemic. The common Filipino still struggles
to make ends meet on a day-to-day basis. Hence, to have health or medical security for
the individual and his family will surely be a significant contribution to rebuilding not only
their lives but also our nation.

Therefore, this bill aims to cover indigent and financially incapacitated individuals in
availing or obtaining access to medical care as it would institutionalize the Medical
Assistance to Indigent Patients (MAIP) Program of the Department of Health? which
would guarantee its continued implementation for the benefit of our less fortunate
constituents.

In view of the foregoing circumstances, the passage of this bill is earnestly sought.

Rep. ROBERT NAZAL
Bagong Hererasyon Party-List

hitos://psa gov ph/content/causes-deaths-philippines-preliminary-ianuary-december-2021, Last
Accessed on 29 June 2025.
2 Department of Health (DOH) Administrative Order No. 2020-0060, the “Revised Guidelines on the
Implementation of the Medical Assistance to Indigent Patients (MAIP) Program.”



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

TWENTIETH (20) CONGRESS
FIRST REGULAR SESSION

House Bill No. 760

Introduced by
Rep. ROBERT NAZAL

AN ACT
FOR THE PROVISION OF
MEDICAL ASSISTANCE TO INDIGENT PATIENTS UNDER THE MEDICAL
ASSISTANCE TO INDIGENT PATIENTS (MAIP) PROGRAM AND MANDATING THE
ACCEPTANCE OF LETTERS OF GUARANTEE FROM THE GOVERNMENT AS
PAYMENT FOR MEDICAL OR HOSPITAL BILLS

Be it enacted by the Senate and the House of the Representative of the Philippines in
Congress assembled:

SECTION 1. SHORT TITLE. — This Act shall be known as the "Medical Assistance to
indigent Patients (MAIP) Program Act."

SECTION 2. DECLARATION OF POLICY. - It is the policy of the State that it shall
provide comprehensive health care services to all Filipino and provide free health care
services to indigent.’ It is the State's policy to adopt an integrated 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 and to provide free
medical care to paupers. Towards this end, the State shall provide comprehensive health
care services to all Filipinos through a socialized health insurance program that will
prioritize the health care needs of the underprivileged, sick, elderly, persons with
disabilities (PWDs), women and children and provide free health care services to
indigents and financially incapacitated individuals.

The State through its Department of Health (DOH) Administrative Order No. 2020-0060,
the “Revised Guidelines on the Implementation of the Medical Assistance to Indigent
Patients (MAIP) Program’ attempts to provide universal health care coverage and
financial protection while providing access to health care, to Filipinos, This Act provides
the legislative framework to enhance and strengthen the implementation and realizations
of the objective of the said measure.

3 See Section 2 of Republic Act No, 10606 or the National Health Insurance Act of 2013.


SECTION 3. COVERAGE. - This Act shall apply to the following health facilities and
offices: DOH Central Office, Center for Health Development units (CHDs) and the Ministry
of Health-Bangsamoro Autonomous Region in Muslim Mindanao (MOH-BARMM), DOH
Hospitals including Specialty and Special, DOH-Drug Abuse Treatment and
Rehabilitation Centers (OOH-DATRC), Department of National Defense (DND) Hospitals,
Department of the Interior and Local Government (DILG) including Local Government
Units (LGUs) and Philippine National Police (PNP) Hospitals, Department of Justice
(004) Infirmaries, State Universities and Colleges (SUCs) Hospitals, and Private
Hospitals and Private Health Facilities.

SECTION 4. DEFINITION OF TERMS. — As used in this Act, the following terms shall
mean:

A. Basic or ward accommodation — refers to the provision of regular meal, bed in
shared room, fan ventilation, and shared toilet and bath.

B. Case Rate — refers to fixed-rate or amount that Philhealth will reimburse for a
specific illness/case as defined by Philhealth Circular No. 0035 s. 2013 and other
related Philhealth Circulars.

C. Catastrophic Disease — refers to a severe illness requiring prolonged hospitalization
or recovery. These include, but not limited to, cancer, psychiatric conditions, heart
attack or stroke, and severe, life-threatening, and long-term effects of diabetes.
These ilinesses usually involve high costs of bills and medical expenses causing
financial hardship which may incapacitate he person from being productive.

D. Catastrophic Health Expenditure — refers to out-of-pocket spending for health care
that exceeds a certain allotted portion of a household's income consequently
rendering the household financially incapable of addressing other domestic and
related expenses.

E. Compassionate Drug Use ~ refers to the use of drugs or medicine not included in
the Philippine National Formulary by patients with serious or life-threatening
conditions when no other treatments are available.

F. Health facility — refers to government and private hospitals licensed by the DOH
and/or accredited by the Philhealth, with the capacity to subsidize medical
assistance and expenses and which can comply with the MAIP Program
documentary/reportorial requirements necessary for the implementation of the
MAIP Program as specified in Section 3.

G. MAP Program Beneficiary — refers to an indigent and financially incapacitated
patient who demonstrates clear inability to pay or spend for necessary expenditures
for one’s medical treatment, such as patients with catastrophic illness, or any illness,
which 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, as assessed and certified by the Medical Social Worker (MSW).

MAIP Program Fund — refers to the fund intended for the medical assistance to
indigent and financially incapacitated patients.

Non-basic ward accommodation ~ refers to accommodation in the health facility,
which is not in the category of basic ward accommodation.

Total Charges — refer to the hospital bill and cost of services including, but not limited
to, medical, surgical and professional fees incurred by a patient seeking care in a
health facility.

SECTION 5. GENERAL MECHANISMS. —

1

The Malasakit Program Office (MPO) formerly known as the Public Assistance Unit
(PAU) of the Central Office of the Department of Health, shall be responsible for the
overall management and administration of the MAIP Program.

The MAIP Program shall provide support for drugs, medicine, medical/orthopedic
devices, dental services (except those that are for aesthetic purposes and not
medically indicated) or other medically related needs prescribed by the physician of
a health facility for in-patients and out-patients in excess of the packages/case rates
covered by PhilHealth or other financing sources subject to the availability of funds.
All participating hospitals/institutions/office units shall strictly observe the
implementation process under the MAIP Program.

All DOH Hospitals (including Specialty and Special Hospitals) and UP-PGH shall
use the Enhanced Web-Based Public Assistance Information System (EWEBPAIS).

The DOH, through the MPO, and the CHDs in coordination with the Field
Implementation and Coordination Team (FICT), shall establish connections and
linkages with other health facilities for a more integrated and interconnected
efficiency. For the CHDs, a Regional MAIP Program Coordinator shall be
designated to ensure that these guidelines are strictly observed. For hospitals, the
Director/Chief of the health facility shall assign the Head of the Medical Social
Services as Hospital MAIP Program Coordinator.

The Coordinator shall be responsible for the overall management, registry of
patients, coordination, program monitoring, and submission of reportorial
requirements including monthly financial report to the CHDs, Financial Management
Services (FMS), and the MPO.

The Administrative and Financial Management Team (AFMT) through the FMS and
the MPO, shall facilitate the efficient sub-allotment and transfer of MAIP Program


funds to the CHDs and Health Facilities. Release of subsequent medical assistance
by the DOH to health facilities shall be made only when at least fifty (50%) of the
amount previously sub-alloted/transferred has been liquidated and submitted to the
CHD concemed, and stamped received by the Commission on Audit (COA). It shall
also adhere to the terms of agreement set by the DOH Central Office and CHD for
the efficient, seamless, and orderly implementation of the Program.

7. Health facilities shall enforce a diligent and thorough screening of beneficiaries to
ensure efficient and rational use of funds and reliable documentation and encoding
of data through the system prescribed by the DOH.

8. No medical assistance provided under the MAIP Program shall be converted into
cash.

9. The DOH shall post in its website the name of recipient hospitals, number of patients
‘served ad total amount or value of provided medical assistance. The DOH's web
administrator or its equivalent, the Knowledge Management, and Information
Technology Service, and the MPO, shall be responsible for ensuring that the said
information are posted on the DOH website.

SECTION 6. ELIGIBILITY OF BENEFICIARIES AND DOCUMENTARY
REQUIREMENTS. — All MAIP Program beneficiaries as defined shall be eligible for
medical assistance under the Program subject to terms and conditions. Patients availing
of coverage or benefits shall go to the Medical Social Service or the Designated Officer
of the health facility for presentation of documents, assessment, and evaluation. A referral
may be issued by the Central Office and CHD. Documentary requirements shall include
but not be limited to for in-patient: total charges and assessment of the MSW of the
Hospital or Municipal/City Social Welfare Officer for those in LGU Hospital: for out-patie
doctor's presoription/requesorder and assessment of the MSW; for referred patient:
inter-agency referral form with attached physician's prescription or request or protocol,
and Medical Certificate or Clinical Abstract. Patients who are in need of medicine or drugs
shall be examined by a doctor of the recipient or serving hospital. For non-ambulatory
patients, a physician's certificate attesting to the veracity of the physical condition of the
patient shall be required.

SECTION 7. ACCESS PROCEDURES TO BE FORMULATED. — The Department of
Health and other line agencies and concemed government offices shall formulate rules,
regulations, and guidelines as to procedures that covers the following:

A. Eligibility Assessment - The Medical Social Worker (MSW) shall assess patients
applying for medical assistance.

B. Processing of Medical Assistance - The MSW shall then process the making
available of the medical assistance to the applying patient.


C. Provision of Service - Health facilities shall provide the necessary health/medical
services, and document the said provision or medical attention/service provided to
the patient.

SECTION 8. COVERAGE OF SERVICE. - The MAIP Program fund shall over essential
and life-saving medicine, services, and other medical products as prescribed by a
licensed physician or health professional such as but not limited to the following:

‘A. Drugs and medicines included in the Philippine National Formulary and those which
qualify for compassionate drug use in compliance with the criteria or requirements
set by the Food and Drug Administration.

B. _ Laboratory, imaging, radiological, and other diagnostic procedures.
C. Blood and other related blood screening/products.

All clinically indicated medical, surgical, high-risk cases of obstetrics —
gynecological, ophthalmological, dental, implants, medical devices and supplies,
and other relevant procedures.

E. _ Incase of non-availability of clinically indicated drugs and medicines, services, and
procedures, and lack of available beds in the government health facility as certified
by the Chief of Hospital or his/her designated official, the concerned health facility
may enter into a Memorandum of Agreement with the DOH licensed and Philhealth
accredited government/private health facility to provide the needs of the patient
charged to MAIP Program funds, subject to the guidelines set by the DOH and
COA's accounting rules and regulations.

F. Prescribed post-hospitalization, rehabilitation services, aftercare program, mental
and psychosocial support.

G. All hospital bills including professional fees, provided that the expenses for the
professional fees shall not exceed 50% of the approved amount for medical
assistance.

SECTION 9. LETTERS OF GUARANTEE FROM THE GOVERNMENT AS
MECHANISM OF PAYMENT. - Both private and public hospitals or health facilities shall
receive letters of guarantee from the government as payment for the indigent or financially
incapacitated patients. Hospitals or health facilities, whether private or public, shall accept
the said letters of guarantee as payment by the said patient, and no such hospital or
health facility shall refuse to accept the said letter of guarantee. Provided, that the
government, through the responsible agency, such as the DOH, or its authorized line
agency, office, unit, or instrumentality, shall actually remit payment to the hospital or


health facility that provided medical care not later than fifteen (15) days from the receipt
of such letter of guarantee.

SECTION 10. ORDER OF CHARGING. — The MAIP Program funds shall primarily cover
the essential and life-saving medicine, total charges, fees, services and other medical
products, provided that coverage from other funding sources for medical assistance has
already been deducted in harmony with the Joint Administrative Order No. 2018-0001 of
the Department of Health (DOH), Department of Social Welfare and Development
(DSWD), Philippine Health Insurance Corporation (PhilHealth), and the Philippine Charity
Sweepstakes Office (PCSO), entitled “Streamlining Access to Medical Assistance Funds
of the Government” and its amendments

SECTION 11. TERMS AND CONDITIONS FOR COVERAGE — The following are the
terms and conditions of access to and implementation of coverage under the MAIP
Programs funds:

A. MAIP Program beneficiaries shall be admitted to basic or non-private ward
accommodation and may be admitted to the next available private accommodation
‘only on the following conditions:

i. Lack of basic or non-private ward accommodation as certified by
the hospital.

Emergency cases.

Cases involving communicable diseases requiring isolation
including Public Health Emergencies of International Concern
(PHEIC)

iv. Cases requiring intensive care; and

v. Chronic and catastrophic cases requiring prolonged admission.

B. Patients confined in non-basic ward accommodation who requests medical
assistance may be covered by MAIP Program funds upon the submission of
documents, subject to the availability of funds.

C. _MAIP Program funds shall be valid from the date of issuance until December 31 of
th same year of issuance except for MAIP Program funds transferred to LGU
hospitals which have a validity petiod based on pertinent National Budget Circulars
applicable to the period.

D. Not more than 1% of the total MAIP Program funds shall be used for administrative
expenses which shall be controlled and monitored by the DOH Central Office.


SECTION 12. PARTNERSHIPS WITH GOVERNMENT/PRIVATE HEALTH FACILITY
OR HOSPITAL, — Subject to the provisions of the General Appropriations Act (GAA), the
CHD may enter into a Memorandum of Agreement or partnership agreements with
government or private hospitals or health facilities, to enable more access to health and
medical services for more indigent or financially-challenged patients. The MOA or
contractual/partnership or joint venture agreement shall be cleared by the DOH Legal
Service or the Legal Section/unit under the Management Support Services Division of the
CHD, as the case may be.

SECTION 13. FUND AUTHORIZATION - The following are the officials authorized to
approve funds, subject to corresponding amounts or limits of authority:

A. For the Health Facilities — the Chief of Hospital of LGU hospitals or selected private
health facilities or his/her duly authorized representative; Chief of Hospital, Medical
Center Chief, Medical Director, or his or her duly-authorized representative.

B. For the DOH — CHD Director, Undersecretary or Head Executive Assistant,
Secretary of Health or designated Chief of Staff.

SECTION 14. RECORDING AND REPORTING —

A. Goverment/private health facilities or hospitals shall submit a monthly fund
utilization report to the CHD concerned. DOH Hospitals shall submit said report
directly to the MPO. Concerns and issues encountered in the implementation of the
Program shall also be included in the report.

B. The CHD shail submit to the MPO a Monthly Summary Report on the status of the
implementation of the MAIP Program, including information on the number of
patients served, type of assistance provided and the actual amount utilized.

C. The reports shall be subject to validation by the MPO.

The MPO shall submit to the Administrative and Financial Management Team
(AFMT), a Quarterly Summary of the Fund Utilization Reports and the status of the
MAIP Program.

E. The MPO through the AFMT shall provide the Secretary of Health a monthly report
of the number of indigent and financially incapacitated patients assisted under the
MAIP Program.

SECTION 15. MONITORING AND EVALUATION — A team from the DOH Central
Office/CHDs shall conduct a quarterly monitoring and evaluation of hospitals using the
MAIP Program monitoring tool. A periodic Program Implementation Review shall be


conducted by the MPO/CHDs to assess the impact of the Program. The Internal Audit
Service of the DOH may conduct a random audit in the CHDs and partner health facilities
and hospitals.

SECTION 16. ROLES AND RESPONSIBILITIES. - The Department of Health, through
its Administrative and Financial Management Team (AFMT) shall be responsible for
‘overseeing the overall implementation of the Program, reviewing and authorizing release
of funds, provision of technical direction to the Program.

1) The Department of Health under its line offices and units shall be responsible for:

The Center for Health Development shall manage allocated funds and
facilitates efficient transfer of funds to partner health facility or hospital under
their jurisdiction, designate CHD Coordinator who shall primarily handle
program implementation and ensure administrative support, submit periodic
reports, and conduct regular monitoring and evaluation, review, request and
authorize release of funds, report any suspected abuse or mishandling of funds
to the MPO, and recommend the appropriate course of action.

The Malasakit Program Office shall facilitate policy development and formulate
monitoring tool for the implementation and evaluation of the MAIP Program,
oversee implementation of the MAIP Program and fund utilization in the
Malasakit Centers, consolidate reports, report any suspected abuse or
mishandling of funds.

The Field Implementation and Coordination Team shall be responsible for
ensuring smooth coordination between CHDs and DOH Hospitals, establishing
linkages for implementation of the program, ensuring that referral of MAIP-
related assistance requests received at the DOH Central Office is forwarded
to the MPO or concemed CHD.

The Financial Management Service team shall provide technical assistance on
matters of financial management, facilitate timely transfer or sub-allotment of
funds to CHD and health facilities in coordination with the MPO, monitoring of
fund utilization reports.

2) The Government/Private Health Facility shall be responsible for: assessing and
screening eligibility of all patients, facilitate provision of quality medical assistance
and ensure the compassionate delivery of necessary services to the MAIP Program
beneficiary, ensuring monthly reporting of fund utilization and program
implementation reports, ensuring administrative support for the effective
implementation of the program, report any suspected abuse or mishandling of funds
to the MPO, facilitate issuance of internal policy to support implementation of the
MAIP Program.


SECTION 17. IMPLEMENTING RULES AND REGULATIONS. — Within sixty (60) days
from the effectivity of this Act, the DOH and other concerned line agencies, offices, or
units, instrumentalities and sectors, shall promulgate the implementing rules and
regulations as may be necessary to carry out the provisions of this Act.

SECTION 18. SEPARABILITY CLAUSE. — If any part of this Act shall be held
unconstitutional or invalid, other parts not otherwise affected thereby shall remain in force
and effect.

SECTION 19. REPEALING CLAUSE. - All laws, decrees, resolutions orders, or
ordinances or parts thereof inconsistent with this Act are hereby repealed, amended, or
modified accordingly.

SECTION 20. EFFECTIVITY. — This Act shall take effect fifteen (15) days after its
publication in the Official Gazette or in at least two (2) newspapers of general circulation.

Approved,