NINETEENTH  CONGRESS OF THE
REPUBLIC OF THE  PHILIPPINES
Second Regular Session
HOUSE OF REPRESENTATIVES
H.B. No.9 4 5 3
Introduced  by Representative Ralph G.  Recto
AN ACT
PROVIDING  HEALTH  CARE  PLAN  COVEIIAGE TO GOVERNMENT PERSONNEL,
PROVIDING FUNDS THEREFOR, AND FOR OTHER PURPOSES
EXPLANATORY NOTE
Health   care   is  an   expensive   undertaking,   especially  when   funded   solely  by
household  income.  During  the  height  of  the  COVID-19  pandemic,  a  study  made  by
Tabufiar and Dominado estimated that the cost of hospitalization for COVID-19 patients
in  Philippine  General  Hospital  would  generally  range  from  Php51,000  to  Php200,000.
The said costs were even commonly higher in other government and  private hospitals.
Such  levels of unforeseen  expenditure  can  have a  devastating  effect on the  lives and
finances  particularly  of  rank-and-file  employees  of various  government  agencies  and
instrumentalities.
To   address   such   concern,   this   bill   seeks  to   extend   a   Health   Maintenance
Organization  (HMO)  health  care  plan  coverage  to  qualified  government  personnel  in
addition to the medical and health benefits and entitlements granted under the National
Health   Insurance   Program   of   the   Philippine   Health   Insurance   Corporation.   Such
intervention  could   have  several   positive  impacts  on  both  the  government  and  the
personnel  concerned.  The  provision  of  HMO  health  care  plans can  help  reduce  health
risks of covered  personnel  by providing the means to consistently and timely attend to
their medical needs. It can also provide an additional safety net for personnel diagnosed
with  critical  illness,  ensuring  the  availability  of financing  for  urgent  medical  concerns.
HMO health care plans can  unburden government medical assistance programs by


providing   an   additional   channel  for  financing   health   interventions  for  hundreds  of
thousands  of government  personnel.  Ultimately,  this  intervention  can  promote  public
service  by  ensuring  that  government  personnel,  particularly  those  engaged  in  critical
and frontline services,  remain  healthy,  able and driven to deliver quality service to the
Filipino  people.
In  light of the foregoing, the approval of this bill  is earnestly sought.
/mdg
2


NINFTEENTH  CONGRESS OF THE
REPUBLIC OF THE  PHILIPPINES
Second Regular Session
HOUSE OF REPRESENTATIVES
H.B.No.9453
Introduced by Representative Ralph G.  Recto
AN ACT
PROVIDING  HEALTH  CARE  PLAN  COVERAGE TO GOVERNMENT PERSONNEL,
PROVIDING FUNDS THEREFOR, AND FOR OTHER PURPOSES
Be it enacted  by the Senate and  House of Representatives of the Philippines in
Congress assembled..
1                   Section  1.  Short 77£/e, -This Act shall  be known as the  "GOMer77menf pErso„"a/
2      Health care Act",
3                  Sec.  2.  Oec/ar?i/ar  of po/y.cy,  -It  is  hereby  declared  a  policy  of the  State  to
4       promote the welfare  of government  personnel.  In  line with  this,  and  in  recognition  of
5      the   constitutional   directive  to   provide  for  the   standardization   of  compensation   of
6      government officials and  employees,  the state shall formulate and  adopt mechanisms
7       to provide a health care plan coverage forall qualified personnel of government agencies
8       and instrumentalities including state universities and colleges (SUCs), and government-
9       owned and/or -controlled corporations (GOCCs).
10                   Sec. 3.  Oe#n/f7.on of Terms. -As used in this Act:
11                    (a)   Oepe„c/enfs shall  refer to   the  legal  spouse,  the  children  and  stepchildren
12       and the parents of the qualified government personnel;
13                    (b)  #ea/Z]4 Care f}/an shall  refer to  a  menu of medical  and  health care services
14      that would  be  provided  for a  specified  period  of time  in  exchange for the  payment of
15       premium;
L6                    (c)   Health  Maintenance  organizations  or  HMOs s;heNJ rofer to |ur;idic:fat  errRE+es
17       duly licensed or authorized by the Insurance commission (IC) to provide or arrange pre-
Page 1 Of 3


1       agreed or designated  health  care services to its enrolled  members for a fixed  pre-paid
2      fee fora specified period of time; and
3                   (d)   Owa/I.rfed  Goi4err7menf  PErso„ne/ shall   refer  to   individuals  appointed   to
4      regular A/anf/'//a items in government agencies and instrumentalities including sucs, and
5       GOCCs.
6                  Set.  4.  Government  Personnel  Health  Care  Plan.  -  AI  oineurfiied  gr]Nerrmfut
7       personnel shall be provided with an annual health care plan offered by HMOs:  Pyioi//.dec/,
8      That  such  health  care  plan  shall  be  in  addition  to  health  benefits  and  entitlements
9       provided  under the National  Health Insurance program as provided  under Republic Act
10       No.11223,  otherwise known as the ``Universal  Health care Act''.
11                   Sec.  5.   renm5  of serv/.ce.  -The  heads  of  agencies  in  the  case  of  national
12      government agencies and the governing  boards  in the case of SUCs and GOCCs,  shall
13      determine the terms of reference for the procurement of HMo health care plans for the
14      personnel of their respective agencies:  Proi//.dec/, That the  HMO  health care plan to be
15       procured  shall,  at  the  minimum,  provide  for  the  following  medical  and  health  care
16       services:
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
a)   Annual physical examination;
b)  Outpatient care including, but not limited to, medical consultations, treatment
for  minor  injuries,  minor  surgical  procedures,  laboratory  examinations,  and
djagnostic procedures;
c)   In-patient care including, but not limited to, room and board, use of operating
and recovery rooms, professional fees, drugs and medicines, medical supplies
and  medical procedures;
d)   Dental  care  including,   but  not  limited  to,  dental  consultation,   dental   pain
treatment, oral prophylaxis, simple tooth extraction, and  permanent filling;
e)   Emergency care and ambulance service;
i)    Preventive  health care including,  but not limited to,  medical  management of
health concerns,  health education and counselling, and family planning;
g)   Coverage of pre-existing  medical and health conditions;
h)   Network access to accredited hospitals and clinics;  and
i)    Medico-legal service.
Page 2 of 3


1                    Government agencies that are already providing HMo health care plan coverage
2      to their respective personnel  prior to the effectivity of this Act may continue with their
3      existing  health  care plan coverage:  Prow/`dec/, That the existing  health care plan of the
4      government  agency  concerned  complies  with  the  minimum  medical  and  health  care
5      services enumerated  in this section:  Pyiov#.dec/,  /wrdher, That in  no way shall this Act be
6      construed  to  diminish  or  reduce  any  health  care  coverage  which  the  government
7       personnel  are  already  receiving  or  any  entitlement  under existing  laws,  issuances,  or
8      collective bargaining agreements between the government agency concerned and their
9      respective personnel.
yf )                   Sie!c. 6.  Health care coverage for Dependents of Qual.ified Government personnel.
11      -The  HMO  concerned  may,  at  the  option  of the  government  personnel  concerned,
12      enroll  dependents  of  qualified  government  personnel  to  the  health  care  plan  of the
13      government agency concerned:  P7iov\i.dGc/, That the premium for HMo health care plan
14      coverage for the dependents shall be borne by the government personnel concerned.
15                   Sec.  7.  4fxpnof}rlaf/an5.  -The  amount necessary for the implementation  of this
16       Act shall  be included  in the annual General Appropriations Act.
[]                   Sac. 8. Implementing Rules and Regulations. -W.rNhin rin€ty (9Un drrrys a[rfer the
18      approval   of   this   Act,   the   Department   of   Budget   and   Management,Civil   Service
19      Commission and the Department of Health shall, in consultation with the Ic, Government
20       Procurement and policy Board and other government and non-government stakeholders
21       concerned,  issue the  necessary  rules  and  regulations for the effective  implementation
22       of thisAct.
23                   Sec.   9.   SepaHa4/.//fy  C)yaw5e,   -   Should   any   provision   of  this   Act   be   found
24       unconstitutional  by a  court of law,  such  provision shall  be severed from the remainder
25       of this Act, and such action shall not affect the enforceability of the remaining provisions
26       of thisAct.
27                   Sec.10.  A}epea//.#g a/awse, -All  laws, decrees,  letters of instruction,  resolutions,
28      orders or parts thereof which are inconsistent with the provisions of this Act are hereby
29       repealed,  modified or amended accordingly.
30                   Sec.   11.   flffgct/.I//fy,  -  This  Act  shall  take  effect  fifteen   (15)  days  after  its
31       publication in the  offcfa/Gazeffeor in any national newspaper of general circulation.
Approved,
Page 3 of 3