Republic of the Philippines

HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

FIFTEENTH CONGRESS
First Regular Session

G54
HOUSE BILL No,__ 9924

Introduced by: HON. LORETO LEO S. OCAMPOS

EXPLANATORY NOTE

e State envisions a country of men and women at the prime of health and optimal
n its declaration of principles and state policies, it incorporated the following:

“The State shall protect and promote the right to health of the people and instill health

consciousness among them”.
Ic also provides for “adequate social services, xxx and an improved quality of life for all”

In consonance with its policy, a National Health Insurance Program for all Filipinos and the
Philippine Health Insurance Corporation (PhilHealth) was established to ensure sustainable,
affordable and progressive social health insurance which endeavors to influence the delivery of an
accessible quality health care for all Filipinos. PhilHealth provides its members with inpatient care

benefits that they may avail of in accredited government and private hospitals.

‘The PhilHealth’s Indigent Program (IP) was established as an insurance plan for the poor.
‘The premium is subsidized by the local government budget. The IP covers care in public rural health
units (RHUs) and in hospitals. However, because there are limitations to PhilHealth benefits and
there are times that the Indigent member exceeds inpatient allowance, they are constrained to leave

the hospital surreptitiously although unwell, to escape the balance of the hospital fees due them.

‘This bill seeks to bolster the ideology that healthcare services must be made available and
accessible to all especially to the underprivileged. It proposes the government to assume the balance
not covered by the inpatient care benefits to lessen the economic burden of the poor members of

the sociery,

‘The immediate passage of this bill is earnestly sought.

RETO LEO S. OCAMPOS
Representative
2™ District, Misamis Occidental


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

FIFTEENTH CONGRESS
First Regular Session
3921

HOUSE BILL No. _

Introduced by: HON. LORETO LEO S. OCAMPOS

AN ACT PROVIDING SETTLEMENT OF HOSPITAL FEES IN EXCESS OF THE AMOUNT
COVERED BY THE NATIONAL HEALTH INSURANCE PROGRAM FOR INDIGENT
MEMBERS

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

SECTION 1. Title. — This Act may be known as the PHILHEALTH INDIGE

MEMBI HOSPITAL PRIVILEGE ACT .

SECTION 2. Definition. ~
a. Indigent - A person who has no visible means of income, or whose income is
insufficient for the subsistence of his family, as identified the Local Health Insurance
Office and based on specific criteria set by the PhilHealth Corporation.
b. Excess Hospital Fee. — The balance of hospital charges after deducting the allowances
provided for by the coverage of the PhilHealth Program.

SECTION 3. Identification of Indigent Members. — ‘The identification of indigent
members shall be undertaken through the conduct of a social research survey, referred to as the
est, to determine the current socio-economic and health profile of the indigent sector in each
The Community-Based Information System — Minimum Basic Needs (CBIS-MBN) approach
administered at the barangay level by the City/Municipal Social Welfare and Development Office
(C/MSWDO) and/or the Barangay along with a government accredited people’s organization and
shall be inter-phased with the means test protocol. The Corporation, however, reserves the right t0
adopt other means test mechanisms as it may deem appropriate

me

SECTION 4. Annual Evaluation of the List of Indigents. ~ ‘The list of indigent
members shall be evaluated every year through a procedure prescribed by the Corporation in
coordination with the concerned LGU.

SECTION 5. Provision for the Settlement of Excess Hospital Fee. — The National
Government thru PhilHealth shall assume the balance not covered by the revised inpatient care
benefits as provided for by PhilHealth.

SECTION 6. Implementing Agency. - ‘The Department of Health and Philitealth
implementing agencies for this Act. The above agencies shall formulate the implementing rules and
regulations for this Act

SECTION 7. Sepatability Clause. ~ If any provision or part thereof, is held invalid or
unconstitutional, the remainder of the law or the provision not otherwise affected shall remain valid
and subsisting,


SECTION 8. Repealing Clause. — Any law, presidential decree or issuance, executive
order, letter of instruction, administrative order, rule or regulation contrary to, or inconsistent with
the provisions of this Act is hereby repealed, modified or amended accordingly.

ETO LEO S. OCAMPOS
Representative
2™ District, Misamis Occidental