FIFTEENTH CONGRESS OF THE REPUBLIC 
OF THE PHILIPPINES 
First Regular Session 
SENATE 
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Senate Bill No. 44, 
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INTRODUCED BY SENATOR VICENTE C. SOTTO III 
EXPLANATORY NOTE 
One of the pervading social ills at present is rampant drug addiction. Various laws 
have been passed to prevent and control this drug menace. What has been overlooked however 
and has not been properly addressed is the rehabilitation of drug dependents, providing for such 
facilities and medical treatment to ensure their complete recovery and eventual social 
reintegration. 
All over the Philippines, across the regions are private and government-run 
rehabilitation centers. However, based on a 2009 survey, there are 1.7 million drug dependents. 
Of this, only 2000 underwent treatment and rehabilitation. The cost of treatment and 
rehabilitation discourages families of drug dependents to avail of the same. 
This bill therefore proposes that Philippine Health Insurance Corporation (PHIC) 
beneficiaries who are drug dependents and who submit to treatment and rehabilitation to an 
accredited health care provider shall be at an affordable cost. This is pursuant to the 
constitutional mandate, "that the State shall 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." 
Republic Act No. 7875, an Act instituting a National Health Insurance Program 
for all Filipinos and establishing the Philippine Health Insurance Corporation (Philhealth) for the 
purpose was amended by Republic Act No. 9241. This amendment highlighted the inclusion of 
drug abuse and dependency treatment as among those personal services covered. It also 
recognized rehabilitation centers as health institutions that are considered as health care 
providers. 
This bill further proposes amendment to specifically include rehabilitation 
treatment as among the enumerated categories of personal health services to ensure its 
beneficiaries of affordable rehabilitation treatment. This bills also calls for the application for 
accreditation of Rehabilitation Centers in order that Philhealth members will be accorded the 
proposed benefits. 
The approval of this proposed bill, is therefore, 
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IlEN~SOT 0 III 
Senator 


FIFTEENTH CONGRESS OF THE REPUBLIC 
OF THE PHILIPPINES 
First Regular Session 
SENATE 
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Senate BIll 'No. 44 
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INTRODUCED BY SEN. VICENTE SOTTO III 
AN ACT 
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PROVIDING FOR AFFORDABLE DRUG REHABILITATION TREATMENT FOR 
PHILIPPINE HEALTH INSURANCE CORPORATION (PHIC) BENEFICIARIES, 
FURTHER AMENDING FOR THE PURPOSE RA 7875, AS AMENDED BY RA 9241. 
Be it enacted by the Senate and House of Representatives of the Philippines in Congress 
assembled: 
SECTION I. This Act shall be known as, "Free Drug Rehabilitation Treatment Act of 
2010." 
SECTION 2. Sec. 4 of Republic Act No. 7875 is hereby amended to read asfollows: 
"Sec. 4. Definition ofTerms.- For the purpose ofthis Act, the following terms shall be defined as 
follows: 
a) Beneficiary - Any person entitled to health care benefits under this Act. 
b) Benefit Package - Services that the Program offers to its members. 
c) Capitation - A payment mechanism where a fixed rate, whether per person, family, household 
or group, is negotiated with a health care provider who shall be responsible in delivering or 
arranging for the delivery of health services required by the covered person under the conditions 
of a health care provider contract. 
d) Contribution - The amount paid by or in behalf of a member to the Program for coverage, 
based on salaries or wages in the case of formal sector employees, and on household earnings 
and assets, in the case of self-employed, or on other criteria as may be defined by the 
Corporation in accordance with the guiding principles set forth in Article 1 of this Act. 
e) Coverage - The entitlement of an individual, as a member or as a dependent, to the benefits of 
the program. 
f) Dependent - The legal dependents of a member are: 1) the legitimate spouse who is not a 
member; 2) the unmarried and unemployed legitimate, legitimated, illegitimate, acknowledged 
children as appearing in the birth certificate; legally adopted or step-children below twenty-one 
(21) years of age; 3)children who are twenty-one (21) years old and above but suffering from 
congenital disability, either physical or mental, or any disability acquired that renders them 
totally dependent on the member of our support; 4) the parents who are sixty (60) years old or 
above whose monthly income is below an amount to be determined by the Corporation in 
accordance with the guiding principles set forth in Article I of this Act. 
g) Drug Dependent - As defined under RA 9165 (Comprehensive Dangerous Drugs Act of 2002), 
a person exhibiting a cluster of physiological, behavioral and cognitive phenomena of variable 
intenSity, in which the use of psychoactive drug takes on a high priority thereby involving, 


among others, a strong desire or a sense of compulsion to take the substance and the difficulties 
in controlling substance-taking behavior in terms of its onset, termination, or levels of use. 
h) Diagnostic Procedure - Any procedure to identify a disease or condition through analysis and 
examination. 
i) Emergency - An unforeseen combination of circumstances which calls for immediate action to 
preserve the life of a person or to preserve the sight of one or both eyes; the hearing of one or 
both ears; or one or two limbs at or above the ankle or wrist. 
j) Employee - Any person who performs services for an employer in which either or both mental 
and physical efforts are used and who receives compensation for such services, where there is an 
employer-employee relationship. 
k) Employer - A natural or juridical person who employs the services of an employee. 
I) Enrollment - The process to be determined by the Corporation in order to enlist individuals as 
members or dependents covered by the Program. 
m) Fee for Service - A reasonable and equitable health care payment system under which 
physicians and other health care providers receive a payment that does not exceed their billed 
charge for each unit of service provided. 
n) Global Budget - An approach to the purchase of medical services by which health care 
provider negotiations concerning the costs of providing a specific package of medical benefits is 
based solely on a predetermined and fixed budget.34urchase of medical services by which health 
care provider negotiations concerning the costs of providing a specific package of medical 
benefits is based solely on a predetermined and fixed budget. 
0) Government Service Insurance System - The Government Service Insurance System created 
under Commonwealth Act No. 186, as amended. 
p) Health Care Provider - Refers to: 
(l) a health care institution , which is duly licensed and accredited devoted primarily to the 
maintenance and operation of facilities for health promotion, prevention, diagnosis, injury, 
disability, or deformity, drug addiction or in need of obstetrical or other medical and nursing 
care. It shall also be construed as any institution, building, or place where there are installed 
beds, cribs, or bassinets for twenty-four hour use or longer by patients in the treatment of 
diseases, injuries, deformities, or abnormal physical and mental states, maternity cases or 
sanitarial care; or infirmaries, nurseries, dispensaries, rehabilitation centers and such other 
similar names by which they may be designated; or 
(2) a health care professional, who is any doctor of medicine, nurse, midwife, dentist, or other 
health care professional or practitioner duly licensed to practice in the Philippines and accredited 
by the Corporation; or 
(3) a health maintenance organization, which is entity that provides, offers, or arranges for 
coverage of designated health services needed by plan members for a fixed prepaid premium; or 
(4) a community-based health organization, which is an association of indigenous members of 
the community organized for the purpose of improving the health status of that community 
through preventive, promotive and curative health services. 
q) Health Insurance Identification (ID) Card - The document issued by the Corporation to 
members and dependents upon their enrollment to serve as the instrument for proper 
identification, eligibility verification, and utilization recording. 


r) Indigent - A person who has no visible means of income, or whose income is insufficient for 
the subsistence of his family, as identified by the Local Health Insurance Office and based on 
specific criteria set by the Corporation in accordance with the guiding principles set forth in 
Article I of this Act. 
s) Inpatient Education Package - A set of informational services made available to an individual 
who is confined in a hospital to afford him with knowledge about his illness and its treatment, 
and of the means available, particularly lifestyle changes, to prevent the recurrence or 
aggravation of such illness and to promote his health in general. 
t) Member - Any person whose premiums have been regularly paid to the National Health 
Insurance Program. He may be a paying member, or a pensioner/retiree member. 
u) Means Test - A protocol administered at the barangay level to determine the ability of 
individuals or households to pay varying levels of contributions to the Program, ranging from the 
indigent in the community whose contributions should be totally subsidized by the government, 
to those who can afford to subsidize part but not all the required contributions for the Program. 
v) Medicare - The health insurance program currently being implemented by the Philippine 
Medical Care Commission. It consists of: 
(I) Program I, which covers members of the SSS and GSIS including their legal dependents; and 
(2) Program II, which is intended for those not covered under Program I. 
v) National Health Insurance Program - The compulsory health insurance program of the 
government as established in this Act, which shall provide universal health insurance coverage 
and ensure affordable, acceptable, available and accessible health care services for all citizens of 
the Philippines. 
w) Pensioner - An SSS or GSIS member who receives pensions therefrom. 
x) Personal Health Services - Health Services in which benefits accrue to the individual person. 
These are categorized into inpatient and outpatient services. 
y) Philippine Medical Care Commission - The Philippine Medical Care Commission created 
under Republic Act No. 6111, as amended. 
z) Philippine National Drug Formulary - The essential drugs list for the Philippines which is 
prepared by the National Drug Committee of the Department of Health in Consultation wit 
h experts and specialists from organized profession medical societies, medical academe and the 
pharmaceutical industry, and which is updated every year. 
aa) Portability - The enablement of a member to avail of Program benefits in an area outside the 
jurisdiction of his Local Health Insurance Office. 
bb) Prescription Drug - A drug which has been approved by the Bureau of Food and Drug and 
which can be dispensed only pursuant to a prescription order from a physician who is duly 
licensed to do so. 
cc) Public Health Services - Services that strengthen preventive and promotive health care 
through improving conditions in partnership with the community at large. These include control 
of communicable and non-communicable diseases, health promotion, public information and 
education, water and sanitation, environmental protection, and health-related data collection, 
surveillance, and outcome monitoring. 


dd) Quality Assurance - A formal set of activities to review and ensure the quality of services 
provided. Quality assurance includes quality assessment and corrective actions to remedy any 
deficiencies identified in the quality of direct patient, administrative, and support services. 
ee) Residence - The place where the member actually lives. 
ft) Retiree - A member of the Program who has reached the age of retirement or who was retired 
on account of disability. 
gg) Self-employed - A person who works for himself and is therefore both employee and 
employer at the same time. 
hh) Social Security System - The Social Security System created under Republic Act No.1 161, 
as amended. 
ii) Treatment Procedure - Any method used to remove the symptoms and cause of a disease. 
jj) Utilization Review - A formal review of a patient utilization or of the appropriateness of 
health care services, on a prospective, concurrent or retrospective basis. 
kk) Rehabilitation Center - Refers to 
I. A facility, which undertakes rehabilitation of drug dependents. It includes institutions. 
agencies and the like which have for their purpose, the development of skills. or which 
provides counseling, or which seeks to inculcate, social and moral values to clientele 
who have a drug problem with the pain of weaning them ji-om drugs and making them 
drug-free, adapted to their families and peers, and readjusted into the community as law-
abiding, useful and productive citizens. 
2. A facility accredited by the Philippine Health Accreditation Board. 
II) Home Care and Medical Rehabilitation Services - Refer to skilled nursing care, which 
members get in their homes/clinics for the treatment of an illness or injury that severely affects 
their activities or daily living. Home care and medical rehabilitation services include hospice or 
palliative care for people who are terminally ill but does not include custodial and non-skilled 
personal care." 
SECTION 3. Section 1 0 of Republic Act No. 7875 is hereby amended to read as follows: 
"Section 10. Benefit Package 
a) Inpatient hospital care: 
1) room and board; 
2) services of health care professionals; 
3) diagnostic, laboratory, and other medical examination services; 
4) use of surgical or medical equipment and facilities; 
5) prescription drugs and biologicals; subject to the limitations stated in Section 37 of this 
Act; 
6) inpatient education packages; 
b) Outpatient care: 
I) services of health care professionals; 
2) diagnostic, laboratory, and other medical examination services; 
3) personal preventive services; and 
4) prescription drugs and biologicals 
c) Rehabilitation Treatment- In-patient care 
1) room and board 


2) services of health care professionals 
3) diagnostic, laboratory, and other medical examination services; 
4) use of medical facilities 
5) prescription drugs and biologicals; 
d )Rehabilitation Treatment -Out-patient Care 
1) services of health care professionals; 
2) diagnostic, laboratory, and other medical examination services; 
3) personal preventive services; and 
4) prescription drugs and biologicals 
d) Emergency and transfer services; and 
e) Such other health care services that the Corporation shall determine to be appropriate and 
cost-effective: Provided, That the Program, during its initial phase of implementation, which 
shall not be more than five (5) years, shall provide a basic minimum package of benefits which 
shall be defined according to the following guidelines: 
I) the cost of providing said packages is such that the available national and local government 
subsidies for premium payments of indigents are sufficient to extend coverage to the widest 
possible population. 
2) the initial set of services shall not be less than half of those provided under the current 
Medicare Program I in terms of overall average cost of claims paid per beneficiary household per 
year. 
3) the services included are prioritized, first, according to its cost-effectiveness and, second, 
according to its potential of providing maximum relief from the financial burden on the 
beneficiary: Provided, That, in addition to the basic minimum package, the Program shall 
provide supplemental health benefit coverage to beneficiaries of contributory funds, taking into 
consideration the availability of funds for the purpose from said contributory funds: Provided, 
further, That the Program progressively expand the basic minimum benefit package as the 
proportion of the population covered reaches targeted milestone so that the same benefits are 
extended to all members of the Program within five (5) years after the implementation of this 
Act. Such expansion will provide for the gradual incorporation of supplementary health benefits 
previously extended only to some beneficiaries into the basic minimum package extended to all 
beneficiaries: and Provided, finally, That in the phased implementation of this Act, there should 
be no reduction or interruption in the benefits currently enjoyed by present members of 
Medicare. 
Section 4. Repealing Clause - All laws, rules, regulations and other issuance or 
parts thereof which are inconsistent with this Act are hereby repealed or modified accordingly. 
Section 5. Effectivity. This Act shall take effect immediately upon its approval.