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SEVENTEENTH CONGRESS OF THE REPUBLIC) otk
(2 JUL Cio

OF THE PHILIPPINES )
First Regular Session )

HOUSE OF REPRESENTATIVE!
H.No. 1457

RLLS AND INDEX SERVICE
Introduced by Representative Herminio Harry =

EXPLANATORY NOTE

Autism S|

ectrum Disorder (ASD), also known as Pervasive Developmental Disorders
(PDDs), causes severe and pervasive impairment in thinking, feeling, language, and the
ability to relate to others. This disorder is usually first diagnosed in early childhood, and
range from a severe form, called autistic disorder, through pervasive development disorder
not otherwise specified (PDD-NOS), to a much milder form, Asperger syndrome. It also

includes two rare disorders, Rett syndrome and childhood disintegrative disorder.

There is no single best treatment for children with ASD. Decisions about the best
treatment, or combination of treatments, should be made by the parents with the assistance of
experts, In some cases, however, the cost of treatment is prohibitive. Hence, this bill seeks to
provide parents and their children access to treatment by requiring health insurers to provide
full coverage not only for treatment but also the prevention, early detection, and diagnosis of

ASD?

JAW

HERMINIO HARRY L. ROQUE JR.

! hutp://www.nimh.nih, gov/healthitopics/autism-spec~m-disorders-pe-asive-developmental-disorders/index.sh~
? This bill was originally filed by Senator Mirian Defensor-Santiago during the Fourteenth Congress,
Regular Session.



SEVENTEENTH CONGRESS OF THE REPUBLIC)
OF THE PHILIPPINES. )
First Regular Session )

HOUSE OF REPRESENTATIVES

H.No._ 4457

Introduced by Representative Herminio Harry L. Roque Jr.

AN ACT
REQUIRING HEALTH INSURERS TO PROVIDE FULL COVERAGE FOR THE
PREVENTION, EARLY DETECTION, DIAGNOSIS, AND TREATMENT OF
AUTISM SPECTRUM DISORDERS
Be it enacted by the Senate and House of Representatives of the Philippines in
Congress assembled:

SECTION 1. Short Title. - This Act shall be known as the “Autism Prevention, Early

Detection, Diagnosis and Treatment Act.”

SECTION 2. Declaration of Policy. ~ It is a policy of the State to protect the
physical, moral, and social well-being of the people, Towards this end, the State shall exert
efforts to make treatment for autism spectrum disorder more accessible to those with such
ailment by requiring health insurers to provide full coverage for prevention, early detection,

diagnosis, and treatment

SECTION 3. Definition of Terms. — For the purposes of this Act, the term:
(A) “Autism spectrum disorder” means a neurobiological condition that includes
autism, Asperger syndrome, Rett’s syndrome, or pervasive developmental disorder;
(B) “Department” means the Department of Health; and

(C) “Secretary” means the Secretary of Health,

SECTION 4. Creation of an Advisory Panel on Health Insurance Coverage for

Autism Spectrum Disorder. ~


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(A) There is hereby established within the Department of Health an advisory panel
on health insurance coverage for autism spectrum disorder. Such panel shall be composed of
nine (9) members who are experts in health care and appointed as follows: Seven (7)
members who are officers or employees of the Department of Health with a background in
mental health or mental retardation and developmental disabilities shall be appointed by the
President; and the Senate President and the Speaker of the House shall each appoint a
member who is a representative of an autism advocacy group.

(B) Each member shall serve a term of two (2) years. The President shall designate

the Chair of the panel from among his or her app

tees, Vacancies in the membership of
the panel shall be filled in the manner provided for original appointments

The members of the panel shall receive no compensation for their services but shall
be allowed their actual and necessary expenses incurred in the performance of their duties
pursuant to this Act

(C) The advisory panel on health insurance coverage for autism spectrum disorder
shall annually, on or before September first, compile and submit to the Secretary a list of
successful treatment and therapy options for autism spectrum disorder that will be required
to be covered pursuant to this Act.

(D) Within forty-five (45) days of receipt of each list submitted pursuant to
Paragraph C of this Section, the Secretary shall, on an emergency basis, promulgate and
implement rules and regulations requiring coverage for the treatment and therapy options

included in each such list,

SECTION S. Creation of an Autism and Health Insurance Coverage Hotline, —
(A) Within one hundred eighty (180) days of the submission of the initial list to the

Secretary pursuant to Sei

nn 4(C) of this Act, the Department shall establish and operate an
autism and health insurance coverage hotline. The hotline shall be a toll-free, twenty-four
(24) hour a day consumer call center for families with autistic children who have complaints

about or questions on insurers and coverage for autism spectrum disorder. All complaints


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received by such hotline shall be documented and referred to the appropriate official in the
Department for corrective action.

(B) The Department may contract with a qualified non-profit corporation for the
provision and operation of the hotline required by this Section, Any such contract shall only
be awarded after the Department has conducted a request for proposals process, The
Department shall select a non-profit corporation which has the resources and ability to
operate a nationwide hotline, and is staffed by employees and/or volunteers with strong
experience in autism spectrum disorder,

(C) If the Department elects to establish and operate the hotline using its own
personnel and resources, such hotline shall be staffed by officers and employees with strong
experience in autism spectrum disorder. Until the Civil Service Commission shall have
established civil service titles and competitive examinations for positions as employees of
the hotline, the Secretary is authorized to appoint and employ such qualified officers and
employees as shall be necessary to operate the autism and health insurance coverage hotline

(D) The Secretary is authorized to promulgate and implement any rules and

regulations necessary to carry out the provisions of this Act.

SECTION 6. Separability Clause. ~ If any provision or part hereof is held invalid or

unconstitutional, the remainder of the Act or the provision not otherwise affected shall

remain valid and subsisting,

SECTION 7. 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, modi

accordingly

SECTION 8. Effectivity Clause. ~ This Act shall take effect fifteen (15) days after its

publication in at least two (2) newspapers of general circulation,

Approved,
- AW)