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

FIFTEENTH CONGRESS
First Regular Session

Gi 1202

House Bill No.

INTRODUCED BY HON. MARCELINO “MARCY” R. TEODORO

EXPLANATORY NOTE

The delivery of basic health services is a primordial State concern that demands
vigorous pursuits of measures aimed to make health goods and services available to all
people at an affordable cost. Without health as a critical component in socio-economic
development processes, there is no way we can truly ameliorate our people's living condition

Indeed, the health status of Filipinos, despite attempts to improve delivery of basic
health services, has been disappointing and has in fact, never gone even close to minimum
acceptable levels. Compared to other countries, including those in South East Asia, the
Philippines obviously, lags behind in terms of medical health expenditures.

According to some reports, the Philippines allocates only a little over three percent of
its gross domestic product to health care spending, which is way below the 5% benchmark
set by the World Health Organization - and only 13% of this is used for public health.

This measure provides additional benefits and privileges to PHILHEALTH members by
expanding available categories of personal health services granted to the member or his
dependents included in PhilHealth Benefit Package.

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

Ganceimo “MARCY” R. TEODORO
Representative, 1st District
City of Marikina



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

FIFTEENTH CONGRESS
First Regular Session

House Bill No.__ 1202

INTRODUCED BY HON. MARCELINO R. TEODORO

AN ACT
GRANTING ADDITONAL 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”.

SECTION 2. Section 40 of Republic Act No. 7875 is hereby amended to read as
follows:

“Section 40. 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:

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;

Inpatient education packages;

6

B) 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, subject to the limitations described
in Section 37 of this Act;

C) Emergency and transfer services:

D) PREVENTIVE HEALTH CARE SERVICES:
ANNUAL PHYSICAL EXAMINATION AT THE PHILHEALTH
ALLOWED MEDICAL FACILITIES ONLY CONSISTING OF:

1. MEDICAL HISTORY TAKING

2. PHYSICAL EDUCATION

3. CHEST X-RAY

4. LABORATORY CONSISTING OF
a) COMPLETE BLOOD COUNT (CBC)
b) STOOL EXAMINATION (FECALYSIS)
c) URINALYSIS
d) ECG & FBS and

&) 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 be
defined according to the following guidelines:

1) 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 | 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: 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 extend 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 3. All laws, presidential decrees, executive orders and rules and
tegulations or part thereof, contrary to, or inconsistent with the provisions of this
Act, are hereby repealed or modified accordingly.


SECTION 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.

SECTION 5. This Act shall take effect fifleen (15) days after its complete
publication in any two (2) national newspapers of general circulation.

Approved,