Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City
19th CONGRESS
HOUSE BILL NO. ___
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
by Congresswoman Bernadette “BH” Herrera
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 2022.1
1
https://psa.gov.ph/content/causes-deaths-philippines-preliminary-january-december-2
021, Last Accessed on 9 September 2022.
September 19, 2022
10:30 am
4932


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,2 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.
BERNADETTE “BH” HERRERA
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
NINETEENTH CONGRESS
First Regular Session
HOUSE BILL NO. __
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 GOVERNMENTAS 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."
SEC. 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 indigents.3 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.
4932


SEC. 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
(DOH-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 (DOJ) Infirmaries, State Universities and Colleges
(SUCs) Hospitals, and Private Hospitals and Private Health Facilities.
SEC. 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 illnesses
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)
MAIP 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).
h)
MAIP Program Fund – refers to the fund
intended
for
the
medical
assistance
to
indigent
and
financially
incapacitated
patients.
i)
Non-basic ward accommodation – refers to
accommodation in the health facility, which is
not
in
the
category
of
basic
ward
accommodation.
j)
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.
SEC. 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.


2.
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.
3.
All DOH Hospitals (including Specialty and
Special Hospitals) and UP-PGH shall use the
Enhanced
Web-Based
Public
Assistance
Information System (EWEBPAIS).
4.
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.
5.
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.
6.
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
concerned, 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.
SEC. 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-patient: doctor’s prescription/request/order 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.
SEC. 7. Access Procedures to be Formulated. – The Department of
Health and other line agencies and concerned 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.
SEC. 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.
d.
All
clinically
indicated
medical,
surgical,
high-risk cases of obstetrics – gynecological,
ophthalmological, dental, implants, medical
devices and supplies, and other relevant
procedures.
e.
In
case
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.
SEC. 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.
SEC. 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.
SEC. 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.
ii.
Emergency cases.


iii.
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
period
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.
SEC. 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.
SEC. 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.
SEC. 14. Recording and Reporting –
a.
Government/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 shall 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.
d.
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.
SEC. 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.
SEC. 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:
a.
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.
b.
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.
c.
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 concerned
CHD.
d.
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.
SEC. 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.
SEC 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.
SEC. 19. Repealing Clause. – All laws, decrees, resolutions orders, or
ordinances or parts thereof inconsistent with this Act are hereby repealed,
amended, or modified accordingly.
SEC. 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,