EIGHTEENTH CONGRESS OF THE) 
REPUBLIC OF THE PHILIPPINES ) 
’  First Regular Session 
)
SENATE
S. B. No. 1126
'19 
OCT 29 PI TO
Introduced by SENATOR IMEE R. MARCOS
AN ACT
EXPANDING THE PHILHEALTH OUTPATIENT COVERAGE ON DIALYSIS AND 
RENAL REPLACEMENT THERAPY, AND FOR OTHER PURPOSES
EXPLANATORY NOTE
Article II, Section 15 of the 1987 Constitution provides that "the State shall 
protect and promote the right to health o f the people and instill health consciousness 
among them ."further,  Article XIII, Section 11 of the Constitution provides that "the 
State shall adopt an integrated and comprehensive approach to health development 
which shall endeavor to make essential goods, health, and other social services 
available to all the people at affordable cost There shall be priority for the needs o f 
the underprivileged sick, elderly, disabled, women, and children. The State shall 
endeavor to provide free medical care to paupers."
Kidney disease today, particularly end-stage renal disease (ESRD), ranks as the 
7th leading cause of death among the Filipinos; one (1) Filipino develops chronic renal 
failure every hour or, about 120 million Filipinos fall ill due to renal failure every year. 
According to the 2017 Philippine Renal Disease Registry, almost twenty-two thousand 
Filipino patients underwent dialysis in 2016.
Most Filipinos, however, cannot afford the exorbitant cost of medical treatment 
for kidney disease. Renal transplantation, on the other hand, is limited due to the 
expense and shortage of donors.


1 
In 2015, PhilHealth issued Circular No. 022 expanding dialysis coverage from
2 
45 to 90 free sessions a year. Each beneficiary receives a case rate amount of PhP
3 
2,500 a session; but as the agency itself admitted, a patient with kidney disease
4 
usually needs dialysis thrice a week, for a total of 144 sessions a year. This means the
5 
patient still has to pay for the 54 sessions in excess of the PhilHealth coverage.
6
7 
In line with Republic Act No. 11223 or the "Universal Health Care Act", this bill
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seeks to further expand the PhilHealth coverage of dialysis patients to include
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expenses in all dialysis treatments as well as the expenses of donors for renal 
10 
transplantation procedures.
For the abovementioned reasons, the passage of this bill is earnestly so u ^t.
fMErtTMARCOS


EIGHTEENTH CONGRESS OF THE) 
REPUBLIC OF THE PHILIPPINES ) 
First Regular Session 
)
■19 
OCT 29 °1 :36
SENATE
S.B. No. 1126
Introduced by SENATOR IMEE R. MARCOS
AN ACT
EXPANDING THE PHILHEALTH OUTPATIENT COVERAGE ON DIALYSIS AND 
RENAL REPLACEMENT THERAPY, AND FOR OTHER PURPOSES
Be it enacted by the Senate and the House o f Representatives o f the Philippines in 
Congress assembled:
1 
SECTION 1. Short Title. - This Act shall be known as the "Comprehensive
2 
Dialysis and Renal Replacement Therapy Act."
3 
SEC. 2. Declaration o f Policy. - The State shall endeavor to make essential
4 
goods, health and other social services available to all the people at affordable cost,
5 
as well as to improve the delivery of health care services to the people and to ensure
6 
hospital facilities are available, affordable and accessible to the people.
7 
It is a declared policy of the State to adopt an integrated and comprehensive
8 
approach to health development that will provide Comprehensive Renal Replacement
9 
Therapy (RRT) to improve the delivery of health care services to patients diagnosed
10 
with End Stage Renal Disease (ESRD), and to encourage them to have a kidney
11 
transplant, primarily within the first two (2) years of starting dialysis.
12 
SEC. 3. Definition o f Terms. - As used in this Act:
13 
a. 
Dialysis facility refers to a health facility that provides treatment for ESRD
14 
patients and disseminates information on the various forms of RRT such as
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kidney transplantation, peritoneal dialysis and hemodialysis;
16 
b. 
End Stage Rena! Disease or ESRD refers to the final stage of chronic
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kidney disease in which the kidneys no longer function well enough to meet
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the needs of daily life;
19 
c. 
Hemodialysis or HD refers to a medical procedure to remove fluid and
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waste products from the blood and to correct electrolyte imbalances. This is
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accomplished using a synthetic membrane or dialyzer which is also referred
22 
to as an "artificial kidney":
1


1 
d. 
Indigent p a tie n t refers to a patient who has no source of income or whose
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income is not sufficient for family subsistence as identified by the Department
3 
of Social Welfare and Development (DSWD) through the National Household
4 
Targeting System (NHTS) for Poverty Reduction, or those patients who are
5 
indigents but are not listed in the NHTS as assessed by the provincial social
6 
development officer, city social development officer, or municipal social
7 
development officer, as the case may be;
8 
e. 
Kidney transplant or KT refers to a surgical procedure to place a kidney
9 
from a live or deceased donor into a person whose kidneys no longer function
10 
sufficiently to sustain the person's life;
11 
f. 
No Balance Billing refers to the government policy of not charging the
12 
medical expenses incurred over and beyond the PhilHealth package rates to
13 
a PhilHealth member who has undergone medical treatment:
14 
g. 
Peritoneal dialysis or PD refers to a treatment for kidney failure and a
15 
type of dialysis that uses the person's peritoneum (lining of abdominal cavity)
16 
as the membrane through which fluid and toxic substances are exchanged
17 
with blood;
18 
h. 
PD First Policy refers to the policy where peritoneal dialysis, when feasible,
19 
is offered as the first dialysis modality to RRT patients;
20 
i. 
Rena! replacement therapy or RRT refers to therapy that partially
21 
replaces the functions of the normal kidney. This may be in the form of kidney
22 
transplantation, peritoneal dialysis and hemodialysis.
23 
SEC. 4. Chronic Kidney Disease (CKD) Prevention and Health Promotion.
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- All national, provincial and regional government hospitals with dialysis service facility,
25 
and stand-alone dialysis facilities should establish CKD prevention strategies and
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health promotion activities which include: advocacy activities targeting relatives of
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dialysis patients who are at high risk for developing CKD themselves, the provision of
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instructional materials and regular educational activities on the common symptoms of
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kidney disease such as its risk factors, healthy diet and lifestyle, common tests to
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diagnose kidney disease, the most common causes of kidney failure, and advisories
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on the appropriate protocols for the diagnostic evaluation of possible kidney disease.
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Patients and their relatives should be informed about the availability of the proper
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medicines from government health centers such as those for diabetes and
34 
hypertension, and the importance of the regular intake of medicines and monitoring
35 
of kidney function through regular laboratory testing and regular clinic follow-up with
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a qualified physician. All activities pertaining to the aforementioned programs should
37 
be documented accordingly.


1 
SEC. 5. Philippine Rena! Disease Registry. - Private and public hospitals,
2 
dialysis centers for both HD and PD, and transplant facilities shall be mandated to
3 
report to the Philippine Renal Disease Registry of the DOH the incidence and
4 
prevalence of patients receiving peritoneal dialysis or hemodialysis treatment, and who
5 
have received a kidney transplant as a requirement for the renewal of their respective
6 
DOH licenses to operate a dialysis center or transplant facility. Registration of all
7 
dialysis patients in the PhilHealth dialysis database will be required prior to the
8 
availment of benefits for both peritoneal dialysis and hemodialysis.
9 
SEC. 6. PhilHealth Benefit for Dialysis Treatment. - The PhilHealth shall
10 
cover all expenses for maintenance dialysis treatments, in accordance with the
11 
implementing rules and regulations of R.A. No. 11223, or the "Universal Health Care
12 
Act." The professional fee of the attending physician and hospital charges shall be
13 
included in the PhilHealth benefits for dialysis treatment.
14 
For purposes of providing optimal financial risk protection to the most vulnerable
15 
groups including the poorest of the poor, the "No Balance Billing Policy" of the
16 
government is hereby provided for indigents.
17 
SEC. 7. Dialysis Facility. - A dialysis facility shall be compliant with the licensing
18 
requirements imposed under DOH Administrative Order No. 2012-0001 dated January
19 
26, 2012 for hemodialysis, and PhilHealth-Accreditation for peritoneal dialysis facilities.
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Hospitals without dialysis facilities first put up the necessary equipment and qualified
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Staff to perform peritoneal dialysis services. For hospitals with existing hemodialysis
22 
facilities, a peritoneal dialysis unit shall be established immediately so that this more
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cost-effective dialysis option can be made available to patients. Hospitals shall
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preferentially be provided with the necessary personnel, equipment and supplies as
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required by PhilHealth for accredited facilities.
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SEC. 8. Training fo r Peritoneal and Hemodialysis Treatment and
27 
Services. - The DOH, National Kidney and Transplant Institute (NKTI) and the
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Philippine Society of Nephrology (PSN) shall provide training for medical personnel
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such as physicians to take charge of the hemodialysis and peritoneal dialysis centers,
30 
hemodialysis and peritoneal dialysis nurses, hemodialysis and peritoneal dialysis
31 
technicians, operating room nurses, transplant ward nurses, transplant coordinators,
32 
and non-medical barangay health workers to support home based peritoneal dialysis.
33 
The NKTI shall accredit the centers that can provide training for the above personnel
34 
and training should include hands-on workshops for dialysis.
35 
SEC. 9. PhilHealth Benefit fo r Kidney Transplantation. - All expenses for
36 
kidney transplantation from living donors shall be shouldered by PhilHealth, pursuant
37 
to R.A. No. 1122, or the "Universal Health Care Act." This shall include the cost of
38 
laboratory work-up for both recipient and donor candidate, hospitalization for the
39 
transplant operation including induction immunosuppression and maintenance oral
40 
immunosuppression, machine perfusion of procured organs, the cost for organ


1 
retrieval, all medications required during the hospital stay, as well as post discharge
2 
laboratories.
3 
The cost for organ retrieval and machine perfusion will be established by the
4 
DOH-Philippine Organ Donation Program for all organ procurement organizations.
5 
The PhilHealth shall also cover the evaluation and screening of the kidney donor
6 
and recipient up to the transplant procedure and post-transplantation procedures and
7 
remedies. This is inclusive of both pre- and post-kidney transplantation measures for
8 
the benefit of ESRD patients.
9 
In order to support kidney transplantation as the best treatment option that
10 
provides the highest quality of life for ESRD patients and ensures the return of the
11 
patient to full rehabilitation, the PhilHealth and the Philippine Charity Sweepstakes
12 
Office (PCSO) shall provide support for all maintenance immunosuppression for the
13 
lifetime of the transplant patient, as long as the transplanted organ is functioning and
14 
the patient remains dialysis-independent.
15 
All RRT facilities shall be required to engage in regular organ donation advocacy
16 
activities that will provide education for all Filipinos to carry the organ donor card.
17 
Facilities will likewise establish a potential deceased organ donor referral system that
18 
will identify all potential deceased organ donors to the Philippine Network for Organ
19 
Sharing.
20 
SEC. 10. Rehabilitation Program. - The DOH, in coordination with the
21 
Department of Labor and Employment (DOLE), Technical Education and Skills
22 
Development Authority (TESDA), and the DSWD and other pertinent agencies, shall
23 
establish a comprehensive rehabilitation program for ESRD patients who have
24 
undergone kidney transplant in order to help them reach their fullest physical,
25 
psychological, social, vocational, avocational, and educational potential consistent with
26 
their physiologic or anatomic condition, environmental limitations, life plans and
27 
desires.
28 
SEC. 11. Appropriations. - The initial amount necessary to implement the
29 
provisions of this Act shall be charged against the current year's appropriation of the
30 
DOH and other concerned departments/agencies. Thereafter, such sum as may be
31 
necessary for the continued implementation of this Act shall be included in the Annual
32 
General Appropriations Act.
33 
SEC. 12. Im plem enting Rules and Regulations. - Within sixty (60) days from
34 
the effectivity of this Act, the Secretary of Health, in coordination with the President
35 
of PhilHealth, and the Executive Director of the NKTI, shall issue the implementing
36 
rules and regulations to implement the provisions of this Act.
37 
SEC. 13. Separability Clause. - If any provision or part hereof is held invalid
38 
or unconstitutional, the remainder of the law or the provision not otherwise affected
39 
shall remain valid and subsisting.


1 
SEC. 14. RepeaUng Clause. - Any law, presidential decree or issuance,
2 
executive order, letter of instruction, administrative order, rule or regulation contrary
3 
to or inconsistent with the provisions of this Act are hereby repealed, modified or
4 
amended accordingly.
5 
SEC. 15. Effectivity. - This Act shall take effect fifteen (15) days after its
6 
publication in the Official Gazette or in a newspaper of general circulation.
Approved,