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

NINETEENTH CONGRESS
First Regular Session

14

28
HOUSE BILL NO.

Introduced by Representatives
HORACIO P. SUANSING, JR. and MIKAELA ANGELA B. SUANSING

AN At
PROVIDING FREE DIALYSIS PROCEDURES TO ALL INDIGENT
AND SENIOR CITIZEN PATIENTS

EXPLANATORY NOTE

Article II, Section 15 of the 1987 Constitution provides that the State shall protect and
promote the right to health of the people and instill health consciousness among them.

Over the past few years, the Philippines has experienced a mounting mortality rate due
to kidney failure. Kidney failure has also become the 10" leading cause of mortality in the
country in 2020 and one of the leading causes of hospitalization. Consequently, the number of
dialysis treatments being made in the country has increased to approximately 400 percent in
the past ten years.

Moreover, a significant number of senior citizens face some form of kidney disease or
affliction, such as Chronic Kidney Disease (CKD) and kidney complications due to diabetes,
high blood pressure and heart discase, illnesses more common to the elderly. CKD is a long-
term condition where the kidneys do not function in full capacity. Some estimates show that
10% of the population worldwide is affected by some degree of CKD, and millions die each
year because they do not have access to affordable treatment. CKD is more prevalent among
senior citizens due to the natural aging of the kidneys: after the age of 40, kidney filtration
begins to fall by approximately 1% per year.*

CKD is largely preventable and treatable through dialysis procedures such as
hemodialysis and peritoneal dialysis. The average cost of a hemodialysis session in the
Philippines is about PHP4,500, and patients with higher degrees of CKD and other serious
kidney ailments have to undergo sessions three times in a week. Thus, the total amount of

" https:/ /mb.com.ph/2022/03/08/kidney-health-for-all/

2 https: / /www.worldiidneyday.org/facts/chronic-kidney-disease/

® https: / /www kidney.org/kidneydisease/ global-facts-about-kidney-disease
+ Ibid.

5 https://www.nhs.uk/conditions/kidney-disease/treatment/


expenses for patients who need to undergo hemodialysis sessions three times in a week is
around P13,500 per week (discounting transportation costs to and from dialysis centers). This
amount is a large expense for the average Filipino, especially given the adverse effects of the
COVID-19 pandemic on the economic security of indigent Filipinos, senior citizens and their
respective families.®

Furthermore, while the Philippine Health Insurance Corporation (PhilHealth) increased
its subsidy for patients who need up to the full 144 dialysis sessions for a year of dialysis
treatment last 2021,” the distribution of subsidies for the dialysis treatments of beneficiaries is
being done on a per-year basis, and provision of the subsidy has not yet been institutionalized.

The following measure pursues the provision of free Department of Health (DOH)
approved dialysis procedures to indigent and senior citizen patients afflicted by serious kidney
ailments, in order to alleviate the significant financial burden of their treatments on them and
their families.

In view of the foregoing, the passage of this bill is earnestly sought.

HORAt JUANSING, JR.
2™ District of Sultan Kudarat
“hutps://www.pna gov. ph/articles/1086669#:~:text=The%20average%420cost42001%20a%20hemodialysis?420

session%20in,%E2%80%93%20a%20large%20expense%20 for"420the%20averaze%20Filipino
7 https://www.philhealth gov.ph/news/2021/dialysis_coverage.pdf



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

NINETEENTH CONGRESS
First Regular Session

2814

HOUSE BILL NO.

Introduced by Representatives
HORACIO P. SUANSING, JR. and MIKAELA ANGELA B. SUANSING

AN ACT
PROVIDING FREE DIALYSIS PROCEDURES TO ALL INDIGENT
AND SENIOR CITIZEN PATIENTS

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

SECTION I. Short Title. — This Act shall be known as the "Libreng Dialysis Act of 2022."

SECTION 2. Free Dialysis for All Senior Citizens. — The cost of all the needed hemodialysis,
peritoneal dialysis, and other Department of Health (DOH)-approved dialysis procedures shall
be fully reimbursed by the Philippines Health Insurance Corporation (PHIC):

Provided, That such treatment is availed of at PHIC-accredited hospitals or free-
standing dialysis centers;

Provided, further, That only those procedures that use the dialysis solutions included
in the latest edition of the Philippine National Drug Formulary (PNDF) shall be reimbursed by
the PhilHealth:

Provided, finally, That only laboratory procedures and supplies considered necessary
shall be covered by the PhilHealth, PhilHealth shall, as soon as possible, reimburse all official
receipts for drugs, supplies, and laboratory procedures dated thirty (30) days prior to the date
of the claimed session.

SECTION 3. Free Dialysis Treatment to Indigent Patients. ~The DOH, in coordination with
the PHIC, shall ensure that indigent patients are accorded free dialysis treatments in national,
regional or provincial hospitals. For this purpose, “indigent patient” refers to a patient who has
no visible means of income, or whose income is insufficient for the subsistence of his family,
as identified by the Department of Social Welfare and Development (DSWD).



SECTION 4. Authority to Receive Donations and Exemption from Donor’s Taxes, Customs
and Tariff Duties. - The DOH shall have the authority to receive donations, gifts and bequests,
in order to augment the funding for the establishment of the dialysis clinics created in
accordance with this Act. All donations, contributions or endowments which may be made by
persons or entities to the dialysis clinics in national, regional and provincial hospitals and the
importation of medical equipment and machineries, spare parts and other medical equipment
used solely and exclusively by the dialysis clinics shall be exempt from income or donor's
taxes, any other direct or indirect taxes, wharfage fees and other charges and restrictions.

SECTION 5. Appropriations. — The amount needed for the implementation of this Act shall
be charged against the appropriations of the DOH and the PHIC in the current and subsequent
General Appropriations Act and their own respective funds. Thereafter, the amount needed for
the continued implementation of this Act shall be included in the budget of the concerned
departments in the annual General Appropriations.

SECTION 6. Implementing Rules and Regulations. — Within thirty (30) days from the
approval of this Act, the DOH, the PHIC, the DSWD and the National Commission on Senior
Citizens (NCSC), in coordination with other implementing agencies, shall formulate rules and
guidelines as may be necessary for the proper implementation and enforcement of this Act.

SECTION 7. Repealing Clause. ~ Ail laws, decrees, executive orders, and proclamations,
rules, and regulations or parts thereof inconsistent with this Act are hereby repealed, amended,
or modified accordingly.

SECTION 8. Separability Clause. — If any provision of this Act is held invalid or
unconstitutional, the remaining parts or provisions not affected shall remain in full force and

effect.

SECTION 9. Effectivity. - This Act shall take effect fifteen (15) days after its publication in
the Official Gazette or in a newspaper of general circulation.

Approved,