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Republic of the Philippines

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HOUSEOF REPRESENTATIVES 3

Quezon City ire, AUG 0 12019 @
EIGHTEENTH CONGRESS ne E86 gy
First Regular Session 2 — eal

nouse BiLNo. 3345

INTRODUCED BY HONORABLE CHERYL P. DELOSO-MONTALLA

AN ACT
INSTITUTIONALIZING MALASAKIT CENTERS TO COMPLEMENT THE
IMPLEMENTATION OF REPUBLIC ACT NO. 11223 OTHERWISE KNOWN AS THE
“UNIVERSAL HEALTH CARE ACT” BY REQUIRING PHILHEALTH TO
ESTABLISH, OPERATE AND MAINTAIN MALASAKIT CENTERS IN ALL DOH,
LGU, SUC AND DND HOSPITALS IN THE COUNTRY, PROVIDING FUNDS
THEREFOR, AND FOR OTHER PURPOSES

EXPLANATORY NOTE

In the not so distant past, it was common for a patient's relative to travel to various
government offices to avail of financial assistance for their medical bills, especially those from
indigent families. While there were funds and assistance available, there was also a ton of
paperwork to accomplish before the financial assistance was given. Those who availed were also
required to show a certificate of indigency which proved that they are indeed as poor as they claim
to be. This meant they had to go to their barangay council to request this document, which may
not be given as soon as the applicant might expect as there might be the need to do a home visit.
For a person who needs money for medical care, time is of the essence.'

And thus the Malasakit Center was born, Conceptualized in 2018 by Special Assistant to the
President and now incumbent Senator Christopher Lawrence “Bong” Go, the first Malasakit
Center was established by the government in the Vicente Sotto Memorial Medical Center
(VSMMC) in Cebu City. Seen to effectively ease the process of availing government services for
patients, more Masakit Centers were established. By the first half of 2019, there were about
Malasakit Centers all over the country.

The Malasakit Center is a one-stop shop, a small booth in a public hospital that houses desk
representatives from the Department of Social Welfare and Development (DSWD), Philippine
Health Insurance Corporation (PhilHealth), Philippine Charity Sweepstakes Office (PCSO) and
the Department of Health (DoH). These agencies have agreed to have their respective
Represent yes) present in the Center so that people are able to transact without having to leave the
hospital.

Fully cognizant of the significance of the Malasakit Center, President Rodrigo Roa Duterte
urged Congress to institutionalize this innovative approach to providing financial and other forms
of assistance to Filipino patients. Hence, this bill.

This proposed measure intends to reduce, if not eliminate, out-of-pocket expenditures of
indigent and poor patients including non-medical expenses like transportation costs. Malasakit

+ http://pwdphil.com/2019/05/02/what-is-a-malasakit-center/
2 Ibid. http://pwdphil.com/2019/05/02/what-is-a-malasakit-center/


Centers will also be a Health System Enabler to improve assessment for patient assistance and
referral to provide much needed system support for patient navigation.’

This bill seeks to establish, maintain and operate Malasakit Centers in all DOH, LGU,
DND and SUC hospitals in the country which will house desk representatives from the Philhealth,
DOH and DSWD. The Philhealth representative shall be in charge of assisting and processing the
concerns of both direct and indirect contributors to Philhealth regarding the implementation of
Republic Act No. 11223 or the "Universal Health Care Act" which may include concerns on
coverage, billing, health benefits packages, among others. The DOH representative shall be in
charge of providing medical assistance, while the DSWD representative will be providing financial
or direct assistance. This way we can deliver basic services to communities in the most efficient,
responsive and sustainable manner.‘

Immediate passage of this bill is earnestly sought.

IERYL P. DELOSO-MONTALLA
Representative
2™ District, Zambales

? Explanatory Note of SB No. 199 authored by Senator Christopher Lawrence Go which was filed on 1 July
2019 and entitled, AN ACT INSTITUTIONALIZING MALASAKIT CENTERS TO COMPLEMENT THE
IMPLEMENTATION OF REPUBLIC ACT NO. 11223 OTHERWISE KNOWN AS THE "UNIVERSAL HEALTH CARE
ACT" BY REQUIRING PHILHEALTH TO ESTABLISH, OPERATE AND MAINTAIN MALASAKIT CENTERS IN ALL
DOH, LGU, SUC AND DND HOSPITALS IN THE COUNTRY, PROVIDING FUNDS THEREFOR, AND FOR OTHER
PURPOSES

“Ibid.


Republic of the Philippines
HOUSEOF REPRESENTATIVES
Quezon City

EIGHTEENTH CONGRESS
First Regular Session

HOUSE BILL NO. 3345

INTRODUCED BY HONORABLE CHERYL DELOSO-MONTALLA

AN ACT
INSTITUTIONALIZING MALASAKIT CENTERS TO COMPLEMENT THE
IMPLEMENTATION OF REPUBLIC ACT NO. 11223 OTHERWISE KNOWN AS THE
“UNIVERSAL HEALTH CARE ACT” BY REQUIRING PHILHEALTH TO
ESTABLISH, OPERATE AND MAINTAIN MALASAKIT CENTERS IN ALL DOH,
LGU, SUC AND DND HOSPITALS IN THE COUNTRY, PROVIDING FUNDS
THEREFOR, AND FOR OTHER PURPOSES

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 "Malasakit Centers Act of
2019."

SECTION 2. Declaration of Policies. - It is the declared policy of the State to improve
the delivery of health care services to the people, and to ensure financial assistance for hospital
and medical expenses are available and accessible to the people.

SECTION 3. Definition of Terms. - For purposes of this Act, the following terms shall
mean:

(a) DOH Hospital refers to a refers to a hospital under the management and administration
of the Department of Health (DOH), Including the four (4) corporate hospitals under the Secretary
of Health, namely: Philippine Heart Center, Lung Center of the Philippines, National Kidney and
Transplant Institute and the Philippine Children's Medical Center;

(b)DND Hospital refers to a hospital managed by the Department of National Defense;

(c) Financial Assistance or Material Assistance refers to actual cash or check which covers
burial, transportation, and other allied assistance given by agencies as mandated by existing laws,
rules and regulations to provide such assistance;

(d) Indigent Patient refers to patient who has no visible means of income, or whose income
is insufficient for the subsistence of his/her family, as identified by the Department of Social
Welfare and Development (DSWD), LGU social worker or the medical social worker of the health
facility;



(e) Local Government Unit (LGU) Hospital refers to a hospital managed by the local
government units, usually the provincial government;

(f) Malasakit Center refers to a processing center for Philhealth and one-stop shop for
Filipinos in need of medical assistance;

(g) Medical Assistance refers to assistance for out-of-pocket expenditure in form of
coupon, stub, guaranty letter, promissory note or voucher that has monetary value, given directly
to individual recipients or beneficiaries to address their immediate needs;

(h) Out-of-pocket expenditure refers to medical and surgical services not currently paid for
or sufficiently reimbursed by PhilHealth under Republic Act No. 11223 or the Universal Health
Care Act, or other financing sources;

(i) Poor Patient refers to those not classified as indigent but are otherwise considered poor
or with financial difficulty to access adequate medical care and/or pay hospital bills because of
certain unavoidable circumstance, such as but not limited to:

1. Senior citizens, persons with disability (PWD), orphans, abused women and
children as defined by RA 9262 or the Anti-Violence Against Women and Their Children
Act of 2004 and RA 7610 or the Special Protection of Children Against Abuse,
Exploitation and Discrimination Act; 29

2. Patients with catastrophic illness or any illness as a primary condition that is life
or limb-threatening and requires prolonged hospitalization, extremely expensive therapies
or other special but essential care that would deplete one's financial resources, unless
covered by special health funding policies;

3. Unemployed or without gainful employment;

4. Suspected or confirmed victims of torture as defined by Republic Act No.9745
or the “Anti-Torture Act of2009;”

5. Soldiers and police rendered disabled to be gainfully employed and their
dependents and dependents of soldiers and police killed in action;

6. Rebel returnees, prisoners of war and their dependents;

7. Victims of calamities or disasters such as but not limited to typhoons, earthquake,
whose place of residence are officially under a state of emergency or calamity; and

(j) SUC Hospital refers to hospitals managed by State Universities and Colleges.
SECTION 4. Malasakit Centers. - To complement the implementation of Republic Act

No. 11223, otherwise known as the Universal Health Care Act, there shall be established a

Malasakit Center in each DOH, LGU, DND and SUC hospital in the country which shall serve as

(a) processing center for all Philhealth concerns regarding coverage, billing, health benefits
packages, patient navigation and referral to the health care provider network, and


(b) one-stop shop medical assistance to cover out of-pocket medical expenses of indigent
and poor patients. The Philhealth shall administer and manage the Malasakit Centers in close
coordination with the DOH and DSWD. Each Malasakit Center shall consist of duly designated
representatives from the Philhealth, DOH and DSWD with the following delegation of functions:

1. The Philhealth representative shall be in charge of the over-all operation of the
Malasakit Center. He/she shall assist and process the concerns of both direct and indirect
contributors to Philhealth regarding the implementation of Republic Act No. 11223,
including but not limited to coverage, billing, health benefits packages, financial concerns.
The Philhealth representative shall also assist in patient navigation and referral to the health
care provider network;

2. The DOH representative shall be in charge of providing medical assistance to
indigent and poor patients; and

3. The DSWD representative shall be in charge of providing financial or direct
assistance to indigent and poor patients.

SECTION 5. Provision of Medical Assistance. “The DOH shall provide medical
assistance to indigent and poor patients through the Malasakit Center which shall be charged from
the annual appropriation of the DOH for assistance to indigent patients. The DOH may also
augment medical assistance using the following sources:

a) Other appropriations earmarked by national government agencies and local government
units purposely for medical assistance to indigent and poor patients: Provided, That appropriations
earmarked for a specific hospital shall only be used for that specific hospital; and

b) Donations and grants-in-aid: Provided, That donations and grants donated for a specific
hospital shall only be used for that specific hospital: Provided further. That the donations and
grants shall only be used for the purpose specified by the donor.

‘The DOH shall issue guidelines for the proper implementation of the medical assistance to
indigent and poor patients which shall include order of charging from the aforementioned sources
of financing, availment procedures, transfer and release of funds, recording and reporting,
monitoring and evaluation, partnerships with private hospitals, among others.

The DOH shall make a quarterly report to the Office of the President and Congress
regarding the expenditures or disbursement of the medical assistance to indigent and poor patients

SECTION 6. Medical Assistance. - The Medical Assistance shall cover for medical and
surgical services not currently paid for or sufficiently reimbursed by PhilHealth in accordance with
Republic Act No. 11223 or other financing sources, and shall be used for the following drugs,
medicines, goods and other services prescribed by the physician of the health facility such as but
not limited to:

a. Laboratory, imaging and all other diagnostic procedures;

b. Drugs and medicines included in the Philippine National Drug Formulary (exemptions
to be cleared by Pharmaceutical Division);


c. Supplies, orthopedic/assistive devices, prosthesis, blood and blood products;
d. Dental services, except those that are for aesthetic purpose and not medically indicated;
e. All clinically indicated medical and surgical procedures, whether emergency or elective;

f. Prescribed post-hospitalization rehabilitation services, aftercare program, appropriate
mental and psychological support, including those done on an outpatient basis;

g. In case of non-availability of clinically indicated drugs, medicines, tests, services or
procedures in government health facilities, the concerned government health facility may enter
into contract with DOH-accredited private health facility to provide the needed drug, test, service
or procedure to the patient, charged against the DOH hospital;

h, All hospital bills including professional fees, provided that the expenses for professional
fees shall not exceed fifty percent (50%) of the approved assistance; and

i. All other medical, health, documentary and related services billed by the hospital

Provided, That medical assistance to patients shall be based on need as recommended by
the medical social worker attending physician, approved by the Chief of Hospital/Medical Center
Chief of the institution involved and DOH authorized officials, subject to availability of funds.

SECTION 7. Provision of Financial Assistance. - The DSWD shall provide financial
assistance through the Malasakit Center to indigent and poor patients, individuals in emergency
situations, under distress or are in need of supplemental financial support due to health or medical
conditions, sickness or disease; funeral and burial concerns, which also includes the most direct
and economical transportation expense to or from place of residence or specific destination.

The provision of financial assistance through Malasakit Centers shall be charged to the
annual appropriation of the DSWD for assistance to individuals and families in difficult
circumstances. The DSWD shall issue policies and guidelines on the release of such assistance for
the proper implementation of the program.

SECTION 8. Establishment of Maiasakit Centers. - The Philhealth and DOH shall, in the
establishment of the Maiasakit Centers, undertake consultations with all DOH, LGU, DND and
SUC hospitals; Provided, That in the establishment of the Maiasakit Centers, highest priority shall
be given to those economically-depressed areas or provinces.

Within three (3) years from the effectivity of this Act, the Philhealth and DOH shall
establish Maiasakit Centers down to the Primary and Secondary Care level to help facilitate the
adoption of appropriate health seeking behaviors, assist primary care providers in encouraging
medical consultation at the health centers, monitor patient compliance, and ensure proper patient
referral and availment of benefits.

Private hospitals are hereby encouraged to establish Maiasakit Centers. The Philhealth and
DOH may enter into a Memorandum of Agreement with private hospitals for the establishment of
Maiasakit Centers which shall cater indigent and poor patients of the private hospital


SECTION 9. Donations from Non-Governmental Organizations and the Private Sector.
- The DOH may solicit and receive donations from the private sector for medical assistance to
indigent and poor patients. Such donations shall be exempt from income or donor's tax and all
other taxes, fees and charges imposed by the government: Provided, That donations from the
private sector for a particular hospital shall only be used for the benefit of the patients of the
particular hospital: Provided further, That the donations and grants shall only be used for the
purpose specified by the donor. As such, the donor may send his or her representatives to the
Malasakit Center for the provision of the medical assistance donated by the donor in the particular
hospital.

Receipts from donations, whether in cash or in kind, shall be accounted for in the books of
the DOH in accordance with accounting and auditing rules and regulations. The receipts from cash
donations and proceeds from sale of donated commodities shall be deposited with the National
Treasury and recorded as a special account in the General Fund and shall be available to the DOH.
through a special budget pursuant to Section 35, Chapter 5, Book VI of Executive Order No. 292.
Donations with a term not exceeding one (1) year shall be treated as trust receipts.

The DOH shall submit the quarterly reports of all donations received, whether in cash or
in kind, and expenditures or disbursements thereon with electronic signature to the DBM, through
the Unified Reporting System, and to the Speaker of the House of Representatives, the President
of the Senate of the Philippines, the House Committee on Appropriations, the Senate Committee
‘on Finance and the Commission on Audit, by posting such reports on the DOH website for a period
of three (3) years. The head of the DOH shall send written notice to the said offices when said
reports have been posted on its website which shall be considered the date of submission.

SECTION 10. Appropriations. - The amount necessary to establish Malasakit Centers
shall be included in the General Appropriations Act. Additionally, there shall be an annual
appropriation for the assistance to indigent patients under the DOH specifically for medical
assistance to indigent and poor patients as provided for in Section 5 of this Act, and an annual
appropriation for assistance to individuals and families in difficult circumstances under the DSWD
budget for financial assistance to indigent and poor patients as provided for in Section 7 of this
Act.

SECTION 11. Implementing Rules and Regulations. - Within ninety (90) days from the
approval of this Act, Philhealth, DOH, DSWD, in coordination with Department of Interior and
Local Government shall jointly issue the implementing rules and regulations of this Act.

SECTION 12. Separability Clause. - Any portion or provision of this Act that is declared
unconstitutional shall not have the effect of nullifying other portions or provisions hereof as long
as such remaining portions can still subsist and be given effect in their entirety.

SECTION 13. Repealing Clause. - All laws, ordinances, rules, regulations, other
issuances or parts thereof, which are inconsistent with this Act, are hereby repealed or modified

accordingly.

SECTION 14. Effectivity. - This Act shall take effect fifteen (15) days after its publication
in the Official Gazette or in a newspaper of general circulation.

Approved,