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NINETEENTH CONGRESS ) ECEIVED 2
REPUBLIC OF THE PHILIPPINES )
Third Regular Session )

HOUSE OF REPRESENTATIVES

Introduced by Representative Rufus B. Rodriquez
House Bill No, 11455

EXPLANATORY NOTE

Republic Act 7875, as amended, created the National Health Insurance Program
(NHIP) and established the Philippine Health Insurance Corporation (PhilHealth) to administer
the said Program and manage the National Health Insurance Fund (NHIF). One of its guiding
principles include ‘x x x The Program shall provide all citizens with the mechanism to gain
financial access to health services, in combination with other government health programs.
The National Health insurance Program shall give the highest priority to achieving coverage
of the entire population with at least a basic minimum package of health insurance benefits x
xx"

Related to this, Republic Act 11223 or the Universal Health Care (UHC) Act states that
“x x Every Filipino shall be granted immediate eligibility and access to preventive, promotive,
curative, rehabilitative, and palliative care for medical, dental, mental and emergency health
services, delivered either as population-based or individual-based health services x x x”.

To assist the state in pursuing the aforementioned policies, health institutions were
granted the privilege of applying for accreditation as health facilities (HFs). Under the rules as
promulgated is consonance with RA 7875, Accredited HFs shall extend PhilHealth benefits to
PhilHealth members in the availment of health services and shall reimburse the same with
PhilHealth.

However, in the course of their operations, accredited HF incur violations of the laws,
rules, and regulations in relation to the NHIP, most of which are venial in nature and do not
merit the suspension or revocation of accreditation as the current laws, rules, and regulations
dictate. In fact, there are over One Thousand Five Hundred (1,500) HFs with ongoing
administrative cases in PhilHealth, the implications of which threaten public interest if each of
these HFs will be imposed with suspension or revocation of accreditation

It should be clearly noted that PhilHealth only manages the NHIF and does not have
the capacity nor the mandate to provide healthcare services. They need the HF s to fulfil their
mission, as much as the country does to ensure the well-being of the citizenry. But they are
constrained by laws, rules, and laws which instructs them to impose suspension or revocation
of accreditation.

it is therefore proposed that PhilHealth be mandated by law to adopt an Amnesty
Program which shall absolve all HFs of ongoing cases involving light offenses which does not
compromise the principles and fundamentals of the NHIP or UHC. Aligned with the program
of the President of the Republic, this program may be dubbed as “Bagong Simula para sa
Bagong Pilipinas: Amnestiya para sa mga Pasilidad Pangkalusugan’.

It is also proposed that laws, rules, and regulations related to the imposition of
suspension or revocation of accreditation of HFs be reviewed and amended which will enable
PhilHealth to convert these harsh punishments into monetary value which will be bourne by
HFs as penalties for violations incurred.

This bill seeks to support of the progressive realization of universal health care in the
country and ensure the unhampered delivery of healthcare services in the country.

In view of the foregoing, approval of this bill is eamestly, sought.



NINETEENTH CONGRESS )
REPUBLIC OF THE PHILIPPINES )
Third Regular Session )

HOUSE OF REPRESENTATIVES

Introduced by Representative Rufus B. Rodriguez
House Bill No. 11455

AN ACT
AUTHORIZING THE PHILIPPINE HEALTH INSURANCE CORPORATION (PHILHEALTH)
TO ADOPT AN AMNESTY PROGRAM FOR HEALTH FACILITIES AND SHIFT TO THE
IMPOSITION OF PENALTIES INSTEAD OF ACCREDITATION SUSPENSION OR
REVOCATION

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 “PhilHealth Amnesty for Health
Facilities Act” with the tagline “Bagong Simula para sa Bagong Pilipinas: Amnestiya para sa
mga Pasilidad Pangkalusugan’.

SECTION 2. Declaration of Principle - Its the policy of the State to adopt an integrated and
‘comprehensive approach to health development which shall endeavor to make essential
goods, health and other social services available to all 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.

SECTION 3. Coverage. - This Act shall cover PhilHealth accredited health facilities, whether
private or government-owned.

SECTION 4. Definition of Terms. - The following terms, as used in this Act, shall mean:

Amnesty — Refers to the absolution of administrative cases involving health facilities that
are filed with PhilHealth.

Cases - Administrative cases involving health facilities that are filed with PhilHealth.

Civil Cases — Cases filed with the civil courts involving violations the Civil Code of the
Philippines and other related special laws.

Criminal Cases - Cases filed with the regular courts involving violations of the
CriminalCode of the Philippines and other related special laws.

Health Facilities - Refers to hospitals, clinics, and other healthcare institutions accredited
by PhilHealth to provide healthcare services to PhilHealth members. These facilities are
responsible for the submission of claims for reimbursement of services rendered to
PhilHealth members

PhilHealth Benefits - Refers to the wide-range of benefits provided by PhilHealth to its
members which may be availed at accredited health facilities.

SECTION 5. Amnesty Program for Health Facilities - PhilHealth shall absolve health
facilities of the penalty of suspension or revocation of accreditation for all ongoing cases filed


with its Arbitration/Adjudication Office. Provided, that the health facilities return to PhilHealth
all moneys unduly obtained in the course of the commission of the violation/s, if any. This
Amnesty shall not involve any ongoing or future criminal cases or civil cases that are or may
be filed by PhilHealth against erring Health Facilities for gross violations of the law.

SECTION 6. Conversion of the Suspension/ Revocation of Accreditation with Monetary
Value as Penalty — PhilHealth shall convert the penalty of suspension or revocation of
accreditation with monetary value equitably determined to suit the gravity of violations incurred
by health facilities, and payable in terms as may be determined by PhilHealth, which shall
again be equitably determined. The money value penalties shall not be oppressive but must
serve as a deterrent in order for health facilities to avoid incurring future violations. Provided,
that the health facilities return to PhilHealth all moneys unduly obtained in the course of the
commission of the violations, if any.

SECTION 7. Exclusion — Sections 5 and 6 of this Act shall exclude all gross violations of the
Republic Act 7875, as amended, and Republic Act 11223, and violations of other laws that
prejudice public interest and public funds.

SECTION 8. Implementing Rules and Regulations — PhilHealth shall promulgate the
necessary rules and regulations for the proper implementation of this Act not later than ninety
(90) days from its effectivity

SECTION 9. Separability Clause - If any provision or part of this Act is declared
unconstitutional, the remaining parts or provisions not affected shall remain in full force and
effect.

SECTION 10. Repealing Clause. - All laws, executive orders, rules and regulations, and
issuances or parts thereof which are inconsistent to and contrary with the provisions of this
Act are hereby repealed and amended accordingly.

SECTION 11. Effectivity. - This Act shall take effect fifteen (15) days after its publication in
the Official Gazette or in a newspaper of general circulation.

Approved,