Grae REPaESENTATIVES

RECEIVED
pate: 30 JUy mig
Boe

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

HOUSE OF REPRESENTATIVES,

HB.No. 225

>a TION ONT
X Sieve

BILLS ANN

Introduced by Representative Herminio Harry L. Roque Jr.

AN ACT
PROVIDING FOR FREE HEALTH CARE FOR ALL FILIPINOS

EXPLANATORY NOTE

As of 2013, over 56.3% of total health expenditure was “out-of-pocket” or paid

ctly out of

the hard-earned money of the Filipi

10 people. This is an unfortunate reality inspite of the increasing
budget for the Department of Health, the increase in enrollment for the Philhealth — the national health
insurance program, and the increasing amount earmarked from sin taxes. All this reveals that the

trickle down of public funds towards public health has been unsatisfactory.

‘The Constitution, Article 13, Section 11 provides:

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 of the under-privileged, sick, elderly, disabled, women, and children. The State
shall endeavor to provide free medical care to paupers.

An effective health system focuses both on improving the health of beneficiaries as well as
limiting the financial consequences of medical care. As such, in order to protect the investment of
providing immediate medical assistance, Filipinos who cannot afford treatment should not bear the

heavy weight of paying off these medical services.

Various experts in health policy would agree that the Universal Health Care model of

Thailand is one of the most prolific and successfull models within Asia and the rest of the world. Since


adopting this model, the out-of-pocket expenditures in Thailand has reduced to a low 19.2%. As such,
the Thai National Health Security Act of 2002 served as the main inspiration of this bill. By imitating
their model and creating a National Health Security Office specifically tasked to enforce Universal
Health Care, we move much closer to properly devoting government taxes to save and improve lives

of the Filipino people.

By institutionalizing Universal Health Care, we can guarantee that every Filipino receives the

medical treatment heneeds with the financial assistance he deserves. Unlike contribution-based

programs, the right to Universal Health Care is not dependent on one’s contributions or membership.
Filipinos, especially the poor who do not have regular cash income or struggle to pay premiums, will

be the major beneficiaries of this law. By enacting this bill, we live up to our commitment of ensuring

APA

HERMINIO HARRY L. ROQUE JR.

that those who have less in life should be given more in law.


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

HOUSE OF REPRESENTATIVES

HB.No,__225

Introduced by Representative Herminio Harry L. Roque Jr.

AN ACT
PROVIDING FOR FREE HEALTH CARE FOR ALL FILIPINOS

Be it enacted by the Senate and the House of Representatives of the Philippines in Congress
assembled:

Section 1. Short Title -This Act shall be cited as the “Universal Health Care Law.”
Section 2 Declaration of Policy - 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.

Section 3 Definition of Terms — As used in this act, the term:

(a) “Beneficiaries” shall mean all Filipino citizens entitled to the right to Universal
Health Service.

(b) “Health service” means medical and public health services directly provided to a
person aimed at promotive, preventive, and curative cares, diagnosis, and
rehabilitation.

(©) “Health facility” means public and private health facilities, and such other health
facilities as additionally prescribed by the Board.

(@) “Health care unit” means enrolled health care unit under this Act.

(e) “Network of health care units” means health care units merging and enrolling to be a
network of health care units under this Act.

(£) “Cost sharing”means copayment paid by beneficiaries to a Health care unit per visit,
for the Health service.

(g) “Health service expenses” means any expense borne by a Health service provided by
a health cate unit as follows: prevention and promotion services, diagnosis and
investigation services, ante-natal care, therapeutic items or services, drugs,
biologicals, supplies, appliances, and equipment delivery. bed and board, newborn
care, ambulance or transportation for patients, transportation for a disabled person,
physical and mental rehabilitation, and other expenses necessary for the Health
service as prescribed by the Board,

(h) “Fund” means the National Health Security Fund.



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joard” means the National Health Security Board.

Standard and Quality Control Board” means the board controlling the standard and
quality of the Health service.

(k) “Secretary General” means Secretary General of the National Health Security Office.

(1) “Office” means the National Health Security Office or its subsidiary offices, as a case
may be.

(m)*Official” means any person appointed by the advice of the Board or Quality Control
and Accreditation Board, as the case may be, to perform duties for the execution of
this Act upon the promulgation in the Government Gazette.

(n) “Minister” means the Minister in charge of the execution of this Act.

Seetion 4. Minister of Public Health - The Minister of Public Health shall be in charge and
control of the enforcement of this Act and shall have powers to enact the Ministerial
Regulations or Notifications for the execution of this Act.

Chapter 1
Right to Universal Health Service

Section 5. The Right o Universal Health Service - Every Filipino citizen recognized by the
1987 Constitution shall be entitled to Universal Health Service pursuant to such standards as
prescribed in this Act.

‘The types and limitations of Health services for all beneficiaries shall be prescribed by the
Board.

Except such beneficiaries as prescribed by the Board who shall be entitled to absolutely free
health services,the Board shall have beneficiaries jointly pay for medical costs as prescribed
by the Board to the Health care unit.

Seetion 6. Enrollment of Beneficiaries - Any person with the intent of enjoying the rights
pursuant to Section 5 shall enroll with the Office, the Office’s subsidiaries, or such other
offices as prescribed by the Office to select his personal Health care unit,

Registration to select a personal Health care unit or to change personal Health care unit shall
be pursuant to such regulations, procedures, and conditions as prescribed by the Board,
having mainly regard to personal convenience and necessity.

In the case where any person is entitled to select a Health Care unit pursuant to other rules in
receiving medical welfare or pursuant to his right under other laws, rules, regulations,
notifications, resolutions of the Cabinet, or orders, he shall enjoy his right of Health service at
a Health care unit pursuant to such rules in obtaining medical welfare or his personal rights.

Section 7. Location of Health Service - Enrolled persons shall receive Health service at their
personal Health care unit, primary care unit within the relevant network of Health care units,
or other Health care unit, to which he is referred by his personal Health care unit or network
of Health care units,

However, in cases of emergency illnesses, accidents, or other reasonable causes, an enrolled
person may receive Health service at another health facility as prescribed by the Board,
having mainly regard to their convenience and necessity. A health facility providing such


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service shall be entitled to the reimbursement from the Fund pursuant to such rules,
procedures, and conditions as prescribed by the Board.

Section 8 Any person entitled to the right pursuant to Section 5, who has not
enrolledpursuant to Section 6, shalll receive his first Health service at any Health care unit. A
health care unit providing such service to the said person shall provide them the registration
to select the personal Health care unit pursuant to Section 6 and notify such incident to the
Office within a period of thirty days from the first day of service. For this service, such a
Health care unit shall be entitled to the reimbursement from the Fund pursuant to such
regulations, procedures, and conditions as prescribed by the Board.

Section 9 Limits of the right of Health service of the following persons shall be pursuant to
such laws, rules, regulations, notifications, resolutions of Cabinet or other order
prescribed for the public sector, local government organizations, state enter
state agencies. The said right shall be enjoyed pursuant to this Act.

s or other

(1) Government Official or employee of the public sector;

(2) Oficial or employee of local government organizations:

(3) Official or employee of state enterprises, persons working for other government agencies,
or persons entitled to medical care service from the government budget:

(4) Parent, spouse, child or anyone entitled to medical care service under the right of persons
pursuant to paragraphs (1), (2) or (3).

In the case of paragraph one, the Board shall have duties to provide such a person the access
to Health service pursuant to the agreement between the Fund and the government, local
government organizations, state enterprises or other state agencies, as the case may be.

Seetion 10 Limits of the right to Health service of beneficiaries pursuant to the Social
Security Law shalll be as prescribed by the Social Security Law. The extension of Health
service pursuant to this Act to beneficiaries pursuant to the Social Security Law shall be
pursuant to the agreement between the Board and Social Security Board.

The Board shall make Health service available for beneficiaries pursuant to the Social
Security Law. After entering into an agreement on making Health service available with the
Social Security Board. the Board shall define the period of Health service provided by the
Health care unit to beneficiaries under this Act to the government.

Section 11. Employees covered by the Workmen's Compensation Act - In the case where an
employee, who is entitled to medical care service pursuant to the Workmen’s Compensation
Act, enjoys the right of Health service of a Health care unit pursuant to this Act, the Health
care unit providing Health service shall notify such event to the Office. The Office shall be
entitled to the reimbursement from the Workmen's Compensation Fund, not exceeding such
amount as prescribed in the Workmen's Compensation Law, and shall submit such amount of
reimbursement to the Fund in order to be transferred to the said Health care unit.

Spending Health service expense pursuant to this Section shall be deemed spending part of
medical care expenses pursuant to the Workmen’s Compensation Act.

Section 12 In the case where a victim, caused by a motor vehicle under the Protection for
Motor Vehicle Accident Victims Law. whenever, enjoys the right of Health service from a


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Health care unit pursuant to this Act, the said Health care unit shall notify such event to the
Office. The office shall be entitled to the reimbursement from the Victim Compensation.
Fund, not exceeding such amount as prescribed in the Protection for Motor Vehicle Accident
Victims Law, and shall submit such amount of reimbursement to the Fund in order to be
transferred to the said Health care unit.

In the case where an insurance company is liable to pay the compensation to a motor vehicle
accident victim who has enjoyed the right of Health service in accordance with paragraph
one, the Office shall have powers to issue an order requesting the said company to pay such
Health service expenses, not exceeding the amount in accordance with the conditions of the
insurance policy.

Chapter 2
National Health Security Board

Section 131

ere shall be a board called the “National Health Security Board” made up of:
(1) The Minister of Public Health as a Chairman;

(2) The Secretary of Defense, Secretary of Finance, Secretary of Trade and Industry,
Secretary of the Interior, Secretary of Labor, Secretary of Health, Secretary Education, and
the Budget Secretary:

(3) a representative of each municipal, city, and provincial government:

(4) five representatives of, elected by, representatives each of which from a non-profit private
organization implementing activities for the following groups:

(a) Children and adolescents

(b) Women

(©) Elderly

(d) Disabled or mental health patients
(e) HIV or other chronic disease patients
(1) Labor

(g) Populous communities

(h) Agriculturists

(i) Minorities

(5) five representatives of duly certified health professionals;

(6) Seven persons appointed by the Cabinet, who shall be experts from the fields of health
insurance, medical science and public health, Philippine traditional medicine, alternative
medicine, finance, law and social sciences;

Private organizations pursuant to (4) shall be implemented not less than one year and shall
enroll with the Office within fifteen days from the day of the event causing the appointment
of the member. In the case where any organization has implemented more than one activity, it
shall make enrollment for the election for only one activity.



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Rules and procedures of electing members pursuant to (3) and (4) shall be as prescribed and
promulgated by the Minister.

Members pursuant to (1), (2), (3). (4) and (5) shall search and elect qualified persons and
submit to the cabinet for appointment to be members pursuant to (6).

Rules and procedures of searching and electing qualified members pursuant to paragraph four
shall be as prescribed and promulgated by the Minister.

The Secretary General shall be the Secretary of the Board.

Section 14. Members of the Board holding office pursuant to Section 13 shall not hold office
pursuant to Section 48 at the same time.

Section 15.Members pursuant to Section 13 paragraph one (3), (4). (5), and (6), shall hold
office for a term of four years. A retiring member may be re-appointed, but shall not
successively hold office more than two terms.

Upon the expiration of the term of office, if a new member is not elected pursuant to Section
13 paragraph one (3) (4) and (5) or a new member pursuant to Section 13 paragraph one (6) is
not appointed, the member vacating office pursuant to a term of the office shall hold office to
perform duties until the new member is elected or appointed, but not exceeding ninety days
from the date of expiration of the term of office.

In the case where a member pursuant to paragraph one vacates office during the term of
office, a new member of the same category shall be elected or appointed within thirty days
from the day of vacating office, by an election or appointment of a replacement member, and
the newly elected or appointed member shall hold office for a period equal to the remainder
of the term of office of the member they replaced.

In the case where a member vacates office during the term of office and the remainder of
term of office is less than ninety days, a new member may not be elected or appointed to be a
replacement member. In this event, the Board shall be made up of the remainder of the
members.

Section 16 In addition to vacating office upon expiration of the term of office pursuant to
Section 15 paragraph one, a member pursuant to Section 13 paragraph one (3), (4). (5) and
(6) shall vacate office upon:

(1) death;

(2) resignation:

(3) becoming bankrupt:

(4) becoming an incompetent or a quasi-incompetent person:

(5) being sentenced to imprisonment by final judgment, except a penalty for an
offense board in negligence of misdemeanor:

(6) being convicted to vacate office by the Board's decision with the votes not less
than two third of all members due to his/her improper behavior on performance of
duties.


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Section 17 At a meeting of the Board, there shall be members present in a number not less
than a half of the total number of members to constitute a quorum.

‘The Chairman shall preside over the meeting. If the Chairman is absent, the members present
shall elect a member among themselves to preside over the meeting.

A decision of the meeting shall be by a majority of votes. One member shalll have one vote.
When votes ate tied, the meeting Chairman shall give the casting vote.

In the meeting, a person who is an interested party shall have the right to express his opinion
relating to an issue of the meeting but shall have no right to give his vote.

Procedure of the mecting and performance of the duties of the Board shall be pursuant to the
rules prescribed by the Board.

Section 18 The Board shall have powers and duties as follows:

(1) to prescribe the Health service provided by a Health care unit and Network of health
care units and to prescribe the standard of implementation, regarding national health
security, to be effective:

(2) to provide advice to the minister on the appointment of offi
ministerial regulations and notifications on execution of this Act;

(3) to prescribe limits and types of Health service necessary to health, sustainability, and
the rate of Cost sharing pursuant to Section 5; (4) to prescribe the rules of fund
management and implementation;

(5) to prescribe rules, procedures, and conditions in discharging the Secretary General and
to prescribe qualifications and forbidden qualifications of the Secretary General;

is and the enactment of

(6) to issue rules on money receipt and payment, saving money, and making benefit of the
Fund pursuant to Section 40;
(7} to prescribe rules, procedures, and conditions on payment of preliminary assistance to

reimburse a beneficiary who is subject to damage or injury caused by any service
provided by a Health care unit where the wrongdoer is non-apparent or the wrongdoer is
apparent but such beneficiary can not be reimbursed within a period deemed appropriate
in accordance with section 41;

(8) to encourage and cooperate with local government organizations in implementing and
managing the health security system in local areas by considering their readiness,
reasonableness, and need, in order to establish national health security residents of such
areas as prescribed in Section 47:

(9) to encourage and prescribe rules making it possible that nonprofit community
organizations, nonprofit private organizations and nonprofit private sectors implement
and manage local funds by considering their readiness, reasonableness, and need, by
means and encouraging procedures of participation in order to establish national health
security residents of such areas as prescribed in Section 47;

(10) to prescribe rules in hearing opinions of providers and beneficiaries in order to
improve the quality and standard of Health service:

(11) to prescribe rules on the punishment of administrative fines and revocation of
enrollment
(12) to create reports on implementation and obstacles to implementation of the Board,
and all accounts and finances of the Board in order to annually submit to the Cabinet, the



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House of Representatives, and the Senate within 6 months from the last day of the fiscal
year:

(13) to hold an annual meeting to make it possible that the Board hears general opinions
of providers and beneficiaries:

(14) to perform such other duties as prescribed by this Act, the Minister, or other laws.

Section 19 The Board shall have powers and duties to control and supervise the Office to be
implemented in accordance with the prescribed objectives as follows;

(1) to prescribe the policy of management and consent of the Office's implementation;
(2) to approve the financial plan of the Office:

(3) to control the implementation and general management, to issue rules, by-laws,
notifications, or provisions concerning general and personnel management, budgeting,
finance and properties, to monitor and evaluate. and other implementations of the Office:

Section 20 The Board shall have powers to appoint sub-boards to perform duties pursuant to
this Act or such duties as prescribed by the Board

Section 17 shall apply mutatis mutandis to the meeting, procedure of the meeting, and
performance of Sub-boards or their members.

Section 21 The Board shall appoint an Inspection Sub-board to have powers and duties to
inspect fund management and implementation of the Office in order to enable the
implementation to comply with the relevant laws, rules, and regulations, and to be effective
and transparent, where accountability shall be taken hereto. This shall be as prescribed by the
Board.

Section 22 In performing duties under this Act, the Board or a Sub-board, as the case may be,
shall have powers to summon any state agency or any person to testify to submit statements
or to furnish an object, document or evidence for its consideration.

Section 23 In performing duties, members of the Board and a Sub-board shall earn the
allowance of the meeting, traveling allowance, and such other expenses as prescribed by the
Minister.

Chapter 3
National Health Security Office

Section 24 There shall be a “National Health Security Office” to be the state agency as the
juristic person under control and supervision of the Minister.

Affairs of the Office are not under the Labor Protection, Labor Relations, Social Security,
and Workman’s Compensation laws. Officials and employees of the Office shall be paid
consideration and other benefits not less than such rates as prescribed by the Labor
Protection, Social Security, and Workman's Compensation laws.

Section 25 The Office shall be situated in Manila or in a vicinity province.

‘The Board shall have powers to establish, merge, or liquidate the Office's subsidiaries by
promulgating in the Official Gazette.


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In establishing the Office’s subsidiaries, the necessity and worthiness of the implementation
after comparing with the expenses shall be considered. In this regard, the Board shall have
powers to assign any state or private agency to perform duties as the Office’s subsidiary by
being paid for the expenses of implementation pursuant to such regulations as prescribed by
the Board.

Section 26 The Office shall have powers and duties as follows;

(1) to be responsible for the administration of the Board, the Standard and Quality
Control Board, and Sub-boards of the Board and Standard and Quality Control Board:

(2) to collect, gather, analyze information concerning the implementation of the Health
service:

(3) to create the records of beneficiaries, Health care units, and Networks of health care
units;

(4) to manage the Fund for the execution of such rules prescribed by the Board:

(5) to provide the expenses of such Health service as prescribed by the Board to Health
care units and Networks of health care units pursuant to Section 46.

(6) to inspect documents and evidence of claims submitted by Health care units for Health
service expense
(7) to have people obtain personal Health care units or change personal Health care units,
upon their request, and to launch public relations to make it possible that people have
access to information about Health care unit
(8) to control and supervise Health care units and Networks of health care units in
providing Health service to gain such standard of services as prescribed by the Board and
to facilitate the lodging of complaints:

(9) to be entitled to ownership, possession, and other realty;

(10) to create the rights, to enter into the juristic act or any agreement concerning
property;

(11) to charge fees or service charges for operation of the Office:

(12) to assign other organizations or other persons to act under the powers and duties of
the Office:

(13) to create an annual report as to the performance and obstacles in implementation of
the Board and the Standard and Quality Control Board;

(14) to perform other duties for the execution of this Act or other laws, or other duties
assigned by the Board or Standard and Quality Control Board;

Section 27 Properties of the Office shall not be subject to the execution.

Section 28 The Office shall be entitled to the ownership of immovable properties donated to
the Office, purchased by the Office, or acquired by means of exchanging,

The Office shall have powers to administrate, supervise, maintain, exercise, and supply the
interest from properties of the Office.

Section 29 The Board shall submit a request for the budget of annual expenditure to the
Cabinet to spend for the administration of the Office.

Section 30 The Office shall save and spend budget of the Office pursuant to such rules as
prescribed by the Board


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Accountancy of the Office shall be set up pursuant to such forms and regulations as
prescribed by the Board and shall be subject to an internal inspection on finance,
accountancy, and inventories of the Office. Result of such inspection shall be annually
reported to the Board at least once per year.

Section 31 There shall be a Secretary General of the Office to be in charge of the Office's
administration for the execution of laws, rules, by-laws, provisions, policies, resolutions, and
notifications of the Board and to be the commander of all officials and employees of the
Office. The board shall appoint and discharge the General Secretary.

In employing and appointing the General Secretary, the Board shall elect five members of an
Election Committee with qualifications and without forbidden qualifications as prescribed by
Section 32 (1), (3), (4), (5). (6). (9). (10), (11), and (12)

The Election Committee shall have duties to select persons who have appropriate knowledge
and expertise for the position of Secretary General, with qualifications and without forbidden
qualifications as prescribed by Section 32 (1), (3). (4). (5). (6). (9), (10), (11), and (12). The
selected persons shall not be one of members of the Board and shall not be over 60 years of
age on the day of submitting an application to the Board for consideration to enter into an
employment contract to be appointed to be the Secretary General. The Election Committee
may select and nominate more than such one appropriate person.

Members of Election Committee shall not be nominated to be the Secretary General.

Members of Election Committee shall elect a member among themselves to be a Chairman
and shall elect another member among themselves to be a Secretary.

The Office shall have duties to be the Administrative Unit in searching and electing Secretary
General.

Section 32 Secretary General shall have qualifications and shall not have forbidden
qualifications as follows;

(1) be a Filipino citizen,
(2) be able to work full time for the Office:
(3) not be insane or mentally infirmed:

(4) not be bankrupt:

(5) not have been imprisoned by a final judgment to a term of imprisonment, except for
an offence committed through negligence or a petty offence
(6) not have been subject to a judgment or court order to nationalize his property due to
irregular opulence or getting tremendous property:

(7) not be an executive or an official of another state enterprise or other profit transaction.
(8) not be a government official, an official, or an employee who has position and regular
salary from the central public sector, local public sector, or other state agency:

(9) not be a political official, a member of the House of Representatives, senator, a
member of a local assembly, or a local executive.

(10) not be a committee member or consultant of a political party or not be an official of a
political party:

(11) never having been dismissed or discharged or expelled from a state agency, a state
enterprise, or a public limited company due to bad faith on duties.



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(12) not be or not have been, in the past I year before appointment, a committee member,
an executive, of an authorized person in managing or being interested in a juristic person
who is a contractual party or a coworker or a juristic person who is interested in the
affairs of the Office:

(13) such other qualifications and forbidden qualifications as prescribed by the Board.

Section 33 The Secretary General shall vacate office upon:

(1) death;

(2) resignation;

(3) lacking in qualifications or having forbidden qualifications pursuant to Section 32;
(4) being imprisoned by a final judgment to a term of imprison- ment, except for an
offence committed through negligence or a petty offence:

(5) being absent from the meeting for more than 3 consecutive times without reasonable
excus

(6) being discharged due to defective performance, misconduct, or inefficiency:
(7) employment contract being terminated.

Section 34 The Secretary General shall hold office for a term of four years. The retiring
Secretary General may be re-appointed, but shall not successively hold office more than two
terms.

In the case where the Secretary General vacates office or is temporary not able to perform
duties, the Board shall appoint one of the Office’s officials to be in charge of his/her
functions.

Such appointed official being in charge of the functions of the Secretary General shall have
the same powers and duties as Secretary General’s.

Section 35 The Secretary General shall be a government official, who is deemed an office-
bearer, and forbidden to have personal interests conflicting with the public interests pursuant
to Organic Act of the National Counter Corruption Commission,

Section 36 The Secretary General shall have powers and duties as follows;

(1) to appoint or promote officials and employees of the Office, to reduce or cut down
salaries or wages of officials and employees of the Office, to dismiss the officials and
employees of the Office pursuant to such bylaws prescribed by the Board but to consider
the opinions of the Inspection Sub-board in the case where officials or employees perform
duties in the Bureau of Inspection;

(2) to issue rules or notifications, not contrary to rules, bylaws, notifications, prov ‘sions,
policies, or resolutions of the Board, on implementation of the Office.

For affairs concerning a third party, the Secretary General shall be a representative of the
Office or may authorize any official of the Office to perform specific duties in his stead
pursuant to such bylaws as prescribed by the Board.



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Section 37 There shall be a Bureau of Inspection to be the Office of the Secretary to the
Inspection Sub-board which shall be under the command of the Inspection Sub-board and
shall report to the Secretary General pursuant to such rules as prescribed by the Board.

Chapter 4
National Health Security Fund

Section 38 There shall be a fund in the National Health Security Office called the “National
Health Security Fund” aimed at expenditures to promote and encourage the arrangement of
the Health service of Health care units.

To encourage access by persons to universal and efficient Health service, money of the Fund
shall be spent by considering the development of the Health service in local areas, in which
Health care units are insufficient or Health care units are not appropriate distributed

Section 39 The Fund shall be made up of;

(1) money from the annual expenditure budget;

(2) money from local government organizations as prescribed by law;

(3) money eared by providing Health service pursuant to this Act:

(4) administrative fines pursuant to this Act;

(5) money or property donated to the Fund;

(6) interest or benefit earned by money or property of the Fund; (7) other money or
property eamed by affairs of the Fund:

(8) other contributions as prescribed by law.

Money and property of the Fund shall not be submitted to the Ministry of Finance to be
national income pursuant to the Treasury Balance and Budgetary Procedure Law.

In submitting a request for the annual expenditure budget pursuant to (1), the Board shall
submit the application to the Cabinet by considering the report of Standard and Quality
Control Board’s opinions, accounts. finance, and property of the Office at the time of
application.

Section 40 Money receipt and payment, saving money, and making benefit of the fund shall
be pursuant to such rules as prescribed by the Board

Section 41 The Board shall earmark an amount of money, not exceeding | percent of money
to be paid to Health care units, as preliminary assistance to reimburse beneficiaries who are
subject to damage or injury caused by any service provided by the Health care unit and the
wrongdoer is non-apparent or the wrongdoer is apparent but such beneficiaries can not be
reimbursed within a period deemed appropriate.

This shall be pursuant to such rules, procedures, and conditions as prescribed by the Board.

Section 42 In the case where a beneficiary is subject to damage or injury caused by any
service provided by the Health care unit and the wrongdoer is non-apparent or the wrongdoer
is apparent but such beneficiary can not be reimbursed within a period deemed appropriate
pursuant to section 41, after payment of preliminary assistance to the said beneficiaries, the
Office shall exercise a right of recourse against such wrongdoer.

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Section 43 Within three months from the last day of the fiscal year pursuant to the Treasury
Balance and Budgetary Procedure Law, the Board shall submit last-years balance sheet and
report on money receipt and payment of the Fund of which shall be certified by Oflice of the
Auditor-General to the Cabinet for acknowledgement.

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‘The Minister shall submit the foregoing balance sheet and report on money receipt and
6 payment to the House of Representatives and the Senate for acknowledgement and to be
7 promulgated in the Government Gazette.

8 Chapter 5
9 Health Care Unit and Standard of Health service

10 Section 44 The Office shall organize the enrollment of Health care units and Networks of
11 health care units and set up public relations to people in order that they shall make enrollment
12 to select personal Health care unit pursuant to Section 6.

13. The enrollment of Health care units and Networks of health care units and procedure of
14 public relations pursuant to paragraph one shall be

15 in accordance with such regulations, procedures, and conditions as prescribed by the Board.

16 Section 45 The Health care unit shall have duties as follows:

7 (J)to provide qualified and standard vaccines, medicines, medical supplies, and medical
18 equipment with equity and facilitation of the necessary Health service as well as respect
19 for personal rights in dignity of humankind and religious beliefs;

20 (2) to provide health information requested by beneficiaries, and pursuant to any

21 notification concerning patient and beneficiary rights on procedures, alternatives, and

2 result of diagnosis as well as side-effects which may occur without distortion so that

2 beneficiaries can make their decision to utilize the Health service or to be referred;

24 (3) to provide sufficient information, conceming names of physicians, sanitarian, or

25 person responsible for physical health and society, to relatives or close persons of

26 beneficiaries before discharging:

27 (4) to strictly keep confidence of beneficiaries known by performing duties pursuant to
28 (1) and (2) except disclosing to government officials performing duties pursuant the law:
29 (5) to set up a Health service information system to facilitate a quality and service

30 inspection as well as a request for Health service expense;

31 Health care units shall provide Health service to beneficiaries and set up an information
32. system of Health service information pursuant to such regulations as prescribed by the Board
33 and Standard and Quality Control Board

34 Section 46 Health care units and Networks of health care units pursuant to Section 44 and
35 Health care units taking referral shall earn Health service expenses from the Fund pursuant to
36 such regulations, procedures, and conditions as prescribed by the Board.

37 Opinions in Section 18 (13) shall be considered for the issuance of regulations prescribing
38 Health service expenses and such issuance of regulations shall be at lease pursuant to the
39 following conditions:


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(1) to be based on the Standard Prices of all diseases pursuant to the proposal of Standard
and Quality Control Board;

(2) to cover expenses of Health care units in salaries and considerations for personnel;
(3) to consider the differences of Health care units’ missions

(4) to consider the differences of beneficiaries and the differences of the sizes of Health
care units’ responsible areas;

Seetion 47 To set up national health security for people in local areas by encouraging the
process of participation according to the readiness, reasonableness, and need of people in
such areas, the Board shall support and cooperate with local government organizations
determining regulations so that the said organizations shall implement and manage the
national health security system in local areas by earning expenses from the Fund

Chapter 6
Standard and Quality Control Board

Section 48 There shall be a board called the “Standard and Quality Control Board” consisting
of

(1) The Director General of Department of Medical Services, the Secretary General of the
Food and Drug Administration, the President of the Hospital Development and
Accreditation Institute, and the Director of Division of Medical Registration;
(2) a representative of the Philippines’ Board of Medicine;
(3) a representative of private hospitals;
(4) a representative of the Municipality. City, and Provincial Governments;
(5) a representative of professional nurses, a representative of midwives, a representative
of dentists, and a representative of pharmacists;
(6) representatives of the Philippine General Hospital, each of which is from the field of
obstetrics and gynecology, surgery, internal medicine, and pediatrics:
(7) three representatives elected by, among, representatives of health care professionals,
cach of which is from the field of applied traditional medicine. physical therapy. medical
technique, radiological technology, occupational therapy, cardio-thoracic therapy, and
communicative disorders;
(8) five representatives of, elected by, representatives each of which is from a non-profit
private organization implementing activities for the following groups:

(A) Children and adolescents

(B) Women

(C) Elderly

(D) Disabled or mental health patients

(E) HIV or other chronic disease patients

(F) Labor

(G) Populous communities

(H) Agriculturists

(1) Minorities
(9) six qualified persons appointed by the Minister, each of which, at least, is a qualified
person in family medicine, a qualified person in mental health, and a qualified person in
Philippine traditional Medicine;

Private Organizations pursuant to (8) must have implemented their activities for more than
one year and shall make enrollment with the Office within 15 days from the day of the event

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causing election of a member of the Standard and Quality Control Board. If any organization
implements several activities, it shall make enrollment to be elected for only one activity.

Regulations and procedures of election shall be pursuant to (3) (4) (5) (6) (7) and (8) and
shall be as prescribed and promulgated by the Minister.

Members pursuant to (1) (2) (3) (4) (5) (6) (7) and (8) shall search and elect qualified persons
and submit to the Minister for appointment pursuant to (9).

Regulations and procedures of searching and election pursuant to paragraph four shall be as
prescribed and promulgated by the Minister.

Members pursuant to paragraph one shall elect a member among themselves to be the
chairman of Standard and Quality Control Board.

‘The Secretary General shall be the secretary of Standard and Quality Control Board.

Section 49 Section 14, Section 15, Section 16, and Section 17 shall apply mutatis mutandis to
office holding, office vacation, and the meeting of the Standard and Quality Control Board.

Section 50 The Standard and Quality Control Board shall have powers and duties as follows:

(1) to control the standard and quality of Health care units and Networks of health care
units pursuant to Section 45:

(2) to monitor the Health service provided by Health care units to meet the standard and
quality in the case where such Health care units provide a level of services higher than the
Health service pursuant to Section
(3) to prescribe the measurement, controlling, and encouraging of quality and standard of
Health care units and Networks of health care units;

(4) to submit standard prices of all diseases to the Board to set up regulations prescribing
expenses of Health service to Health care units pursuant to Section 46;

(3) to prescribe rules, procedures, and conditions for the complaint of a person if their
right is violated due to the Health service, procedures for such complaint, and rules and
procedures for assisting a person if their right is violated due to the Health service, as well
as to determine a Complaint Unit to facilitate people in freely submitting complaints,
irrespective of the person who is complaining;

(6) to report the results of inspecting and controlling quality and standard of Health care
units and Networks of health care units to the Board, and notify such result to Health care
units or their authorizing agency in order to improve, modify, monitor, and evaluate the
effect of quality and standard improvement;

(7) to encourage people’ participation in inspecting and controlling Health care units and
Networks of health care units;

(8) provide payment of preliminary assistance to a beneficiary who is subject to damage
or injury caused by any service provided by a Health care unit and the wrongdoer is non-
apparent or the wrongdoer is apparent but such beneficiary can not be reimbursed within
a period deemed appropriate pursuant to such regulations. procedures, and condi- tions as
prescribed by the Board:

(9) to encourage establishing of an information system for deci- sion making of people to
get health service:

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(10) to perform other duties for the execution of this Act and other laws or such duties as
prescribed by the Board.

Section 51 The Standard and Quality Control Board shall have powers to appoint a Sub-
Standard and Quality Control Board to perform duties as assigned by Standard and Quality
Control Board.

Section 17 shall apply mutatis mutandis to the meetings, procedures of the meetings, and
procedures for performing the duties of Sub-Standard and Quality Control Board.

Section 52 The Standard and Quality Control Board or Sub-Standard and Quality Control
Board shall have powers to summon any state agency or any person to testify, to submit
statements or to furnish an object, document or evidence for its consideration.

Section 53 In performing duties, members of the Standard and Quality Control Board and
Sub-Standard and Quality Control Board shall earn the allowance of the meeting, traveling
allowance, and such other expenses as prescribed by the Minis!

Chapter 7 Officials

Section 54 In performing duties on execution of this Act, an official appointed by the Board
or Standard and Quality Control Board shall have powers to enter the premises of Health care
units or Networks of health care units during official times to interrogate for the fact, inspect
property, documents, and evidence, to photograph or to copy relevant document for
inspection, and to do other reasonable matters to obtain the fact for execution of this Act.

For the implementation pursuant to paragraph one, if an offence pursuant to paragraph one is
detected, the official shall have powers to sequester documents, property, or belongings for

consideration

Procedures in performing duties shall be pursuant to such regulations as prescribed by the
Board or Standard and Quality Control Board, as the case may be.

Section 55 In performing duties, an official shall display an identification card to the relevant
person.

‘The identification card of the official shall be as prescribed by the Minister by promulgating
in the Official Gazette,

Relevant persons shall reasonably facilitate the official on duties.

Section 56 On the execution of this Act, the official shall be an official pursuant to the
Criminal Code.

Chapter 8
Health Care Unit Standard Control

Section 57 In the case where the Office inspects and observes that any Health care unit fails
to comply with the prescribed Health service standard, it shall report such inspection to the
Standard and Quality Control Board to appoint an Investigation Committee for consideration.

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The Investigation Committee pursuant to paragraph one shall have a reasonable number of
members, made up of representatives of state agencies in the fields of medical science, public
health, and law, representatives of private organizations, or other qualified persons not
interested in such investigation to conduct investigation and provide opinions to Standard and
Quality Control Board.

The Standard and Quality Control Board may appoint several Investigation Committees in
advance to conduct investigation in a short time.

The investigation shall be completed within 30 days and can be extended to thirty more days.
If the investigation can not be completed within the extended period, it shall be reported to
the Standard and Quality Control Board to be considered and ordered extending to another
more reasonable period,

In performing the execution of this Act. the Investigation Committee shall be official
pursuant to the Criminal Code and shall have powers to summon Health care units,
complainants, or any relevant persons to testify, to submit statements, or to furnish an object,
documents or evidence for its consideration.

After completing the investigation, the Investigation Committee shall submit such account
and its opinions to the Standard and Quality Control Board for consideration.

The Standard and Quality Control Board shall issue orders pursuant to Section 58 or Section
59, as the case may be, within 30 days from the date of receiving such account from the
Investigation Committee.

Section 58 In the case where the result of investigation indicates that the Health care unit
fails to comply with the prescribed standard, the Standard and Quality Control Board shall

(1) issue an order advising such Health care unit to comply with the Standard and Quality
Control Board, in the case of an unintentional act:

(2) issue an order for such Health care unit to be liable to an administrative fine not
exceeding one hundred thousand Baht per act, in case of an intentional act and to apply
provisions concerning administrative enforcement pursuant to public administrative
procedure; in the case of the lack of an official for the enforcement of the order, the
Secretary General has the power to enter an action in the court to enforce the fine and the
‘Administrative Court has the power to sentence and enforce seizing and attaching
property to be sold by auction to pay the penalty;

(3) notify relevant agencies to investigate and judge the allegation or incrimination to
health professionals who may be parily liable for an offence of the Health care unit and to
proceed with disciplinary procedures in the case of a public official;

Section 59 A beneficiary who is not provided reasonable facilitation or facilitation pursuant
to his or her right under this Act from a Health care unit, being overcharged fees for service
exceeding the rate as prescribed by the Board, being charged fees for service by a Health care
unit without authority, or can not be reimbursed for damage or injury caused by the Health
service provided by the Health care unit within a period deemed appropriate, shall lodge his
complaint to the Office for investigation and Section 57 shall apply mutatis mutandis.



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If the result of investigation indicates that the Health care unit has not committed an offence
as it was complained, the Secretary General shall notify the complainant of the result of the
investigation within 15 days from the date of issuing such result.

If the result of investigation indicates that the Health care unit has committed an offence as it
was complained, the Standard and Quality Control Board shall have powers to

(1) advise the Health care unit in writing to treat the complainant properly complying
with his or her rights and benefits, in the case of the complaint for facilitation or benefit
pursuant to the complainant's right.

(2) to issue an order in writing requesting the Health care unit to return monies exceeding
Cost sharing or unjust money with 15% per year interest from the date of charging to the
date of return

Section 60 In the case where the Health care unit’s offense pursuant to Section 58 or Section
59 is serious or recommitted, the Secretary General shall report to the Standard and Quality
Control Board in order to consider proceeding to

(1) issue an order revoking the enrollment of such Health care unit;

(2) notify the Minister in charge of the execution of Health Facility Law to consider
proceeding pursuant to such law.

(3) notify the controlling and monitoring Minister to proceed disciplinary procedure
against executives of the Health care unit, in the case of a Health care unit

(4) notify relevant agencies to investigate and judge such allegation or incrimination to
health professionals who may be partly liable for such offence of the Health care unit and
to proceed disciplinary procedures in the case of a public official;

Section 61 The complaint or Health care unit receiving an order of the Standard and Quality
Control Board pursuant to this Chapter, shall have the right to appeal such order to the Board
within 30 days from the date of receiving or acknowledging the said order, as the case may
be.

‘The decision of the Board shall be final.

Rules and procedures of appeal pursuant to paragraphs one shall be as prescribed by the
Board,

Section 62 After the Appeal Commitice adjudicates an appeal lodged against the order
pursuant to Section 61, the Secretary General shall report such adjudication of appeal to the
Standard and Quality Control Board to be acknowledged,

Chapter 9 Penalties

Section 63 Any person who violates or fails to comply with an order of the Board, Standard
and Quality Control Board, Sub-board, Standard and Quality Control Sub-Board,
Investigation Committee, or Official pursuant to Section 22, Section 52, Section 54, or
Section 57 shall be liable to imprisonment for a term not exceeding six months or a fine not
exceeding ten thousand Baht, or both.



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Section 64 Any person who obstructs or does not provide reasonable facilitation to an official
to perform duties pursuant to Section 55 paragraph three shall be liable to imprisonment for a
term not exceeding six months or a fine not exceeding ten thousand Baht, or both.

‘Transitory Provision

Seetion 65 On the commencement of this Act, Section 6, Section 7, Section 8, Section 11,
and Section 12 shall not apply unless preparation for the availability of Health service
provision has already been set out.

lier preparation for the availability of Health service provision pursuant to paragraph one,
the Minister shall prescribe and promulgate the starting time of Health service in the
Government Gazette, not exceeding one hundred and eighty days from the effective date of
this Act.

In spending Health service expenses pursuant to Section 46 for Health care units under the
Ministry of Public Health, the Office shall provide prior such expenses to the Ministry of
Health for three years from the starting date of the Health service pursuant to paragraph two,

Section 66 Royal decrees pursuant to Section 9 and Section 10 shall be enacted within one
year from the effective date of this Act. If this cannot be done, such period shall be extended
to one more year at a time. The Office and the Social Security Office, as the case may be,
shall report the reason why the investigation cannot be completed within the extended time to
the Minister for acknowledgement and shall distribute such report to the public.

Section 67 The Ministry of Public Health shall elect and appoint members pursuant to
Section 13 (3) (4) (5) and (6) and shalll search and elect the Secretary General to set up the
National Health Security Board pursuant this Act within one hundred and eighty days from
the effective date of this Act.

While the Board pursuant to paragraph one is not set up, there shall be a committee
consisting of the Minister as ChairmanSecretary of Defense, Secretary of Finance, Secretary
of Trade and Industry, Secretary of the Interior, Secretary of Labor, Secretary of Health,
Secretary Education, and the Budget Secretary, and five other qualified persons, four of
which shall be representatives of the Consumers.

The Minister shall appoint a Deputy Permanent Secretary for Public Health to temporarily
perform duties as Secretary General until the inauguration of the Secretary General appointed
in accordance with this Act.

A person appointed by the Minister pursuant to paragraph three shall be the secretary of the
Committee pursuant to paragraph two. The Minister shall appoint two government officials
of the Ministry of Public Health to be assistant secretaries.

Section 68 The Minister shall arrange electing and appointing the Standard and Quality
Control Board pursuant to Section 48 (2), (3), (4), (5). (6) (7) (8) and (9) within one hundred
and eighty days from the effective date this Act

While the Board pursuant to paragraph one is not set up, there shall be a committee
consisting of the Director General of the Department of Medical Services, Secretary General

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of the Food and Drug Administration, President of the Health Facility Development and
Accreditation Institute. Director of the Division of Medical Registration, Secretary of the
Dental Board, Secretary of the Medical Board, Secretary of the Philippine Board of Nursing,
Secretary of the Pharmaceutical Council, President of the Integrated Bar of the Philippines,
and seven other qualified persons appointed by the Cabinet, three of which shall be
representatives of private organizations implementing consumer protection activities, and
four qualified persons in medical science and public health, as members.

Members pursuant to paragraph two shall have a meeting electing a member among
themselves to be Chairman and the elected Chairman shall appoint a secretary from assistant
secretaries pursuant Section 67 and appoint two government officials of the Ministry of
Public Health to be assistant secretaries,

Section 69 The ownership of businesses, properties, rights, obligations, liabilities, and budget
of the Ministry of Public Health relevant to health security pursuant to this Act, as well as the
revolving fund of the Health Insurance Card Project shall be assigned to the Office on the
effective date of this Act.

Section 70 Any government official or employe of the public sector, who voluntarily to
become an official or employee of the Office shall apply in writing to the Commander and
shall be required to be elected and evaluated by such rules as prescribed by the Board.

A government official who becomes an official of the Office pursuant to paragraph one shall
be deemed to have resigned from the public sector because of the termination or dissolution
of his position pursuant to Gratuity and Pension for Officials Law or Gratuity and Pension for
Official Fund Law, as the case may be.

‘An employee who becomes an employee of the Office pursuant to paragraph one shalll be
deemed to have resigned from the public sector because of the dissolution of his position by
the public sector or the termination of employment without liability and shall be entitled to
gratuity pursuant to the Rule of the Ministry of Finance on Employee's Gratuity.

For the calculation of benefit pursuant to bylaws of the Office, a government official or an
employee of public sector, who becomes an official or an employee of the Office pursuant to
this Section shall not successively count his public working period or working time when he
was a government official or employee of public sector, as the case may be, into his working
period at the Office unless waiving his right of gratuity or pension.

Waiving gratuity or pension shall be performed within thirty days from the date of
transference of the official or employee. In the case of a government official, his or her
waiving of gratuity or pension shall be as prescribed by the law of Gratuity and Pension for
Officials or the law of Gratuity and Pension for Official Fund, as the case may be, In the case
ofan employee, his or her waiving of gratuity or pension shall be performed in writing with
his or her signature and submitted to the employer in order to be passed on to the Ministry of
Finance for acknowledgement.

SECTION 71.Separability Clause. - If any provision o part hereof is held invalid or unconstitutional,
the remainder of the Act or the provision not otherwise affected shall remain valid and subsisting.


SECTION 72. 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, modified, or amended accordingly.

SECTION 73.Effectivity Clause. - This Act shall take effect fifteen (15) days after its publication in
at least two (2) newspapers of general circulation.

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