Republic of the Philippines
HOUSE OF REPRESENTATIVES
Constitution Hills, Quezon City

NINETEENTHCONGRESS
First Regular Session

House Bill No. 2578

Introduced by: REPRESENTATIVE EDWIN L. OLIVAREZ

EXPLANATORY NOTE

Chronic kidney disease is not ony a debilitating disease in
its own right, but can also contribute to, or be impacted by, other
prominent chronic diseases, such as but not limited to
hypertension, cardiovascular diseases and pulmonary diseases,
among others. Kidney disease is a very common ailment
worldwide, and if left untreated or not properly attended to it
could lead to hemo or peritonial dialysis which would hasten the
untimely demise of a patient. In the Philippines, kidney disease
is reported as the 7" leading cause of death among Filipinos.
Kidney transplant which is really the only ultimate solution to
kidney failure is too expensive and it usually takes a very long
time to get a kidney donor especially for un-related donation.
Thus, many Filipinos with serious kidney problems heavily, if not
solely, rely on dialysis to survive.

In the current Philhealth package for dialysis patients, only
90 sessions are covered annually with a P2,500.00 case rate.
However, this provision has time and again been proven to be
inadequate as it only covers 45 weeks out of the 52 weeks
comprising a year, assuming a patient is required to undergo
dialysis twice a week, or only 30 weeks out of the 52 weeks,
assuming a patient is required to undergo dialysis thrice a week.
What usually happens therefore is that kidney patients stop
undergoing dialysis towards the latter part of the year due to the
expiration of the coverage of their package being provided by
Philhealth. As a result, these patients personally shell out their

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expenses amounting to P2,800.00 per session in dialysis
treatment which became an enormous burden on the part of
their families. After the expiration of their Philhealth package,
the dialysis treatment of the patients who belong to poor families
became intermittent thus they succumb to death due to their
intermittent or lack of treatment that could have been clearly
preventable in the first place.

A case in point is that of a girl in her very tender years of
15, who was undergoing dialysis in Dasmarinas, Cavite. The
Philhealth coverage of her mother expired by the month of
October. | Being indigent and with not sufficient source of income
to sustain her treatment in the same way as when Philhealth was
still subsidizing it, her family then limited her dialysis sessions to
one or sometimes none at all every week in the months of
November to December, instead of the required three, and also
stopped | availing of the necessary and related medical
interventions such as the injection of epoiten Alfa or Beta
Injections to increase the count of her red blood cells during her
dialysis sessions. As a result, the young girl met her demise
come the month of December of the same year. Although during
her dialysis treatments when Philhealth package had not expired
yet, the child was so vibrant and in fact, could still walk around.

From the foreging, it can be seen that the current Philhealth
coverage for dialysis patients defeats the very purpose and
objective of the healthcare system of our government — which is
to provide the public, especially the poor and the marginalized,
the necessary medical assistance that they otherwise could not
afford. len and women, old and young all suffer the
consequences of this limitation in the State’s healthcare services.
Thus, this bill is being proposed in order to correct this flaw and
ensure that Filipinos suffering from serious kidney disease that
require dialysis are not rendered helpless and hopeless by the
end-months of every year when their Philhealth package has
already been exhausted. This act also aims to make dialysis

totally free-of-charge.
EDWIN L. ees


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Constitution Hills, Quezon City

NINETEENTHCONGRESS
First Regular Session

House Bill No. 2578

Introduced by: REPRESENTATIVE EDWIN L. OLIVAREZ

AN ACT
MANDATING THE PHILIPPINE HEALTH INSURANCE
CORPORATION (PHILHEALTH) TO INCREASE THE
HEMODIALYSIS TREATMENT COVERAGE OF ITS MEMBERS
TO AT LEAST ONE HUNDRED FIFTY SIX (156) SESSIONS
ANNUALLY, AND PROVIDING SAID MEDICAL PACKAGE
FREE-OF-CHARGE TO INDIGENT PATIENTS

Section 1. Short Title. This Act shall be known as the
“Philhealth Hemodialysis Expansion Act of 2022.”

Sec. 2. Declaration of Policy. It is hereby declared as a
policy of the State to ensure that the provision of healthcare
services jis truly adequate, affordable and accessible to the
Filipino people, most especially to those who are considered
indigent, |as defined in this Act.

Sec. 3. Coverage. This Act shall cover Philhealth members,
and their qualified dependents as defined in Section V, Rule I,
Title III of the Revised Implementing Rules and Regulations (IRR)
of the National Health Insurance Act of 2013, otherwise known as
Republic Act (RA) 7875 as amended by RA 9241 and RA 10606.

Sec. 4. Definition of Terms. The following terms, as used
in this Act, shall mean:

Hemodialysis — A medical procedure to remove
fluid and waste products from the blood and to correct


electrolyte imbalances through the use of a machine
anda dialyzer, also referred to as an "artificial kidney."
Hemodialysis is used to treat both acute (temporary)
and chronic (permanent) kidney failure.

Indigent member - For purposes of this Act, an
indigent member shall refer to the Philhealth member:

(1) Whose combined family income does not
exceed Php500,000 pesos annually or which does
not exceed the Philippines’ official poverty line
threshold from the previous year as set by the

Philippine Statistics Authority in consultation
with the appropriate inter-agency technical
committee, whichever is higher; or

(2) Whose income is insufficient for family
subsistence, as identified by the Department of
Social Welfare and Development (DSWD), based
on specific criteria. All indigents identified by the
DSWD under the National Household Targeting
System (NHTS) for Poverty Reduction and other
such acceptable methods.

It is understood that qualified dependents of
the indigent members are also covered by the
benefits and services provided in this Act.
Provided further, that any ambiguity or conflict in
interpretation of the definition of indigency shall
be resolved in favor of the Philhealth member.

Sec. 5. Expansion of the Dialysis Treatment Coverage.
PhilHealth shall increase the coverage for dialysis treatment of its
members, or their qualified dependents as provided in
PhilHealth’s applicable rules and guidelines, from ninety (90)
sessions per year to one hundred fifty six (156) sessions per year,
without further reducing the case rate amount of Two Thousand
Five Hundred Pesos (Php 2,500.00) per session.

Sec. 6. Free Dialysis Treatment for Indigent members.
The annual one hundred fifty six (156) sessions of dialysis
treatment shall be completely free-of-charge or no cash out if the
patient is considered an indigent member as defined under this

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Act. Provided further, that qualified dependents are understood
to also be covered by this provision.

Sec, 7. Application and Certification of Indigency. The
Philhealth member who wishes to qualify under the free dialysis
treatment for indigent members shall apply for a certificate of
indigency at any point within the year. Once approved, the
remaining dialysis sessions required of the patient for the rest of
the year after the Certificate of Indigency is issued shall be free-
of-charge. Said certificate shall be renewable by the end of the
year, in order to avail of the free dialysis treatment for the entire
succeeding year.

Sec, 8. Requirement for Certificate of Indigency.
Philhealth shall endeavor to create an efficient, cost-effective, and
unbureaucratic application process or system including the
documentary requirements, for its members who wish to apply
for a certificate of indigency in order to avail the benefits under
this Act. |

Sec, 9. Implementing Agencies and Rules. Philhealth
shall issue the necessary implementing rules and regulations to
implement the provisions of this Act within ninety (90) days after
its effectivity.

Sec. 8. Separability Clause. If any provision of this Act
is declared invalid or unconstitutional, other provisions hereof
which are not affected thereby shall remain valid, and in full
force and effect.

c. 10. Repealing Clause. All laws, orders, decrees,
rules id regulations and other parts thereof which are
inconsistent with the provisions of this Act are hereby repealed,
amended or modified.

Sec. 11. Effectivity. This Act shall take effect fifteen (15)
days after its publication in the Official Gazette or in two (2)
newspapers of general circulation.

Approved,