TWENTIETH CONGRESS OF THE 
REPUBLIC OF THE PHILIPPINES
First Regular Session
SENATE 
Senate Bill No. 1218
Senate
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1
RECElVtDBY,
Introduced by Senator Erwin T. Tulfo
AN ACT
AMENDING REPUBLIC ACT NO. 11223 
OTHERWISE KNOWN AS THE ‘UNIVERSAL 
HEALTHCARE ACT’, AND FOR OTHER PURPOSES
EXPLANATORY NOTE
One of the general objectives of Republic Act No. 11223 or the 
‘Universal Health Care Act’ is to ensure that all Filipinos are 
guaranteed equitable access to quality and affordable health care goods 
and services, and protected against financial risk. However, in reality, 
many Filipinos—^particularly those in remote and underserved areas— 
continue to face challenges such out-of-pocket expenses preventing 
them from fully benefiting from the law’s objective.
This measure seeks to improve Republic Act No. 11223 or the 
‘Universal Health Care Act’ by making health services more people 
oriented, accessible, affordable, and responsive to the needs of every 
Filipino people.
First, it ensures that all DOH-licensed hospitals recognize the 
National ID as valid proof of PhilHealth membership. While its 
presentation remains optional, if presented, it must be accepted for 
admission or down payment purposes.


Second, it mandates a minimum PhilHealth coverage of 30% for 
members and 50% for OFWs and their dependents in private hospitals, 
regardless of illness, including childbirth. This helps reduce out-of- 
pocket expenses and ensures more inclusive coverage.
Lastly, it requires PhilHealth to submit an annual audit report and 
fund viability plan to the DBM, Senate, and House of Representatives, 
to promote transparency and ensure long-term sustainability of the 
program.
For these reasons, the immediate passage of tl^bill is earnestly 
sought.
ERWIN T. TULFO
I 
V


TWENTIETH CONGRESS OF THE 
)
REPUBLIC OF THE PHILIPPINES 
)
First Regular Session 
)
SENATE 
Senate Bill No. 1218
Senate
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25 AUG 19 P3:05
RECEIVED BY.
Introduced by Senator Erwin T. Tulfo
AN ACT
AMENDING REPUBLIC ACT NO. 11223 
OTHERWISE KNOWN AS THE ‘UNIVERSAL 
HEALTHCARE ACT’, AND FOR OTHER PURPOSES
Be it enacted by the Senate and the House of Representatives of the 
Philippines in Congress assembled:
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SECTION 1. Section 9 of Republic Act No. 11223 is hereby amended
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by inserting a new section to read as follows:
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SECTION 9-A. PRESENTATION OF NATIONAL
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IDENTIFICA TION CARD OR OTHER GO VERNMENT
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ISSUED IDENTIFICATION CARDS. - ALL
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HOSPITALS DULY LICENSED BY THE
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DEPARTMENT OF HEALTH (DOH) SHALL
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RECOGNIZE AND ACCEPT THE NATIONAL
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IDENTIFICATION CARD AS SUFFICIENT PROOF
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OF PHILHEALTH MEMBERSHIP; PROVIDED,
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THAT THE PRESENTATION OF THE NATIONAL
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IDENTIFICATION CARD SHALL NOT BE
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MANDATORY FOR HOSPITAL ADMISSION OR
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FOR THE AVAILMENT OF PHILHEALTH
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BENEFITS; PROVIDED, HOWEVER, THAT IN THE


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ABSENCE OF THE NATIONAL IDENTIFICATION 
CARD, OTHER GOVERNMENT-ISSUED 
IDENTIFICATION CARDS AND PROOF OF 
MEMBERSHIP MAY BE PRESENTED.
THE NATIONAL ID OR OTHER GOVERNMENT 
ISSUED IDENTIFICATION, IF PRESENTED, SHALL 
BE ACCEPTED AS A VALID FORM OF INITIAL 
DOWNPAYMENT FOR HOSPITAL ADMISSION OR 
FOR THE AV AILMENT OF PHILHEALTH 
BENEFITS.”
SEC 2. Section 10 of Republic Act No. 11223 is hereby amended 
by inserting a new section to read as follows:
“SECTION 10-A. MANDATORY MINIMUM 
COVERAGE IN PRIVATE HOSPITALS. 
NOTWITHSTANDING EXISTING POLICIES AND 
BENEFIT PACKAGES, PHILHEALTH SHALL BE 
MANDATED TO SHOULDER AT LEAST THIRTY 
PERCENT (30%) OF THE TOTAL HOSPITAL BILL 
OF ANY MEMBER OR QUALIFIED DEPENDENT 
ADMITTED 
TO 
ANY 
PRIVATE
HOSPITAL, REGARDLESS OF ILLNESS OR 
MEDICAL CONDITION, INCLUDING BUT NOT 
LIMITED TO CHILDBIRTH AND RELATED 
MATERNAL CARE SERVICES.
PHILHEALTH SHALL COVER AT LEAST FIFTY 
PERCENT (50%) OF THE TOTAL HOSPITAL BILL 
OF ANY OVERSEAS FILIPINO WORKER 
(OFW) OR 
THEIR QUALIFIED
DEPENDENTS WHEN ADMITTED TO ANY 
PRIVATE HOSPITAL, SUBJECT TO 
VERIFICATION OF OFW STATUS UNDER THE 
DEPARTMENT OF MIGRANT WORKERS.


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THE COVERAGE HEREIN PROVIDED SHALL 
BE IN ADDITION TO OTHER DISCOUNTS OR 
PRIVILEGES GRANTED UNDER EXISTING LAWS, 
SUCH AS THOSE FOR SENIOR CITIZENS AND 
PERSONS WITH DISABILITIES (PWDS).
PHILHEALTH SHALL ENSURE THE IMMEDIATE 
IMPLEMENTATION OF THIS MINIMUM 
COVERAGE 
WHICH 
SHALL 
BE
AUTOMATICALLY APPLIED AND REFLECTED IN 
THE BILLING PROCESS.”
SEC 3. Section 37 of Republic Act No. 11223 is hereby amended 
by inserting a new section to read as follows:
“SEC. 37-A. SUBMISSION OF AUDIT REPORT AND 
FUND VIABILITY PLAN. - PHILHEALTH SHALL 
SUBMIT THE FOLLOWING REPORTS ANNUALLY 
TO THE DBM, THE SENATE, AND THE HOUSE OF 
REPRESENTATIVES:
(A) MANAGEMENT AUDIT REPORT
DETAILING POLICIES AND REFORMS 
TO 
CONTROL 
FRAUDULENT
PRACTICES; AND
(B) 
FUND VIABILITY PLAN, INCLUDING
POLICIES 
AND 
REFORMS
TO 
STRENGTHEN PREMIUM
COLLECTION, INCREASE PROGRAM 
BENEFITS, AND MINIMIZE THE RISK OF 
DEFICITS.”
SEC. 4. Separability Clause. - Should any provision or part of 
this Act be declared unconstitutional or invalid, the other provisions 
and parts hereof, insofar as they are separable from the invalid ones, 
shall remain in full force and effect.


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SEC. 5. Repealing Clause. - All laws, decrees, orders,
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proclamations, rules and regulations, or parts thereof, which are
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inconsistent with this Act are hereby repealed, amended, or modified
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accordingly.
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SEC. 6. Effectivity. - This Act shall take effect fifteen (15) days
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after its publication in the Official Gazette or in at least two (2)
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newspapers of general circulation.
Approved,