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

FIFTEENTH CONGRESS
First Regular Session

HOUSE BILL No._3099

Intraduced by Rep. Wilfride Mark M. Enverga

EXPLANATORY NOTE

‘The Constitution provides that the State shall promote and protect the
right to health of the people. It is likewise mandated to adopt an integrated and
comprehensive approach to health development and shall endeavor to make essential
good health and other social services available to all the people at affordable cost.

‘Through the National Health Insurance Program (NHIP), more than 30
million indigent Filipinos were granted access to quality health care services. Yet
there is still a need to further expand the coverage of the NHIP to bring the benefits
to even more Filipinos, particularly in the countryside.

‘This bill aims to expand the coverage and enhance the benefit package of
NHIP so as to effectively carry out the PhilHealth mandate to provide health

insurance coverage and ensure affordable, acceptable, available and accessible

health care services for all.

Approval of this measure, therefore, is urgently and earnestly sought.


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

FIFTEENTH CONGRESS
First Regular Session

HousE BILL No._SU99

Introduced by Rep. Wikfride Mark M. Enwerge

AN ACT GRANTING ADDITIONAL BENEFITS AND PRIVILEGES TO PHILHEALTH MEMBERS AMENDING

FOR THE PURPOSE SECTION 10 OF REPUBLIC ACT NO.7875 OTHERWISE KNOWN AS NATIONAL,
HEALTH INSURANCE ACT OF 1995

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

SECTION 1. This Act shall be known as the "Expanded National Health Insurance Act of 2010."
SEC.2. Section 10 of Republic Act. No. 7875 is hereby amended to read as follows:

SEC. 10. Benefit Package. - Subject to the limitations specified in this Act and as may be determined by
the Corporation, the following categories of personal health services granted to the member or
his dependents as medically necessary or appropriate, shall include:

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:
1) services of health care professionals;
2) diagnostic, laboratory, and other medical examination services;
3) personal preventive services; and


4) prescription drugs and biologicals, subject to the limitations described in
Section 37 of this Act;
©) Emergency and transfer services:

D) PREVENTIVE HEALTHCARE SERVICES:
ANNUAL PHYSICAL EXAMINATION AT THE PHILHEALTH
ALLOWED MEDICAL FACILITIES ONLY, CONSISTING OF:
1, MEDICAL HISTORY TAKING
2. PHYSICAL EXAMINATION
3. CHEST X-RAY
4, LABORATORY CONSISTING OF:

8. COMPLETE BLOOD COUNT (CBC)

b, STOOL EXAMINATION (FECALYSIS)
¢. URINALYSIS,

d. ECG & FBS 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:

1) the cost of providing said packages is such thatthe 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
Tin 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
-d, That,
in addition to the basic minimum package, the Program shall provide supplemental health benefit coverage to

potential of providing maximum relief from the financial burden on the beneficiary: Pro

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 mi
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

um benefit

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,


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SEC.

. All laws, presidential decrees, executive orders and rules and regulations or part thereof, contrary
10, or inconsistent with the provisions of this Act, are hereby repealed or modified accordingly.

SEC. 4. Should any provision of this Act be found unconstitutional by a court of law, such provision shall be
severed from the remainder of this Act, and such action shall not affect the enforceability of the

remaining provisions of this Act.

SEC. 5. This Act shall take effect fifteen (15) days after its complete publication in any two (2) national newspapers

of general circulation.

APPROVED,