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SIXTEENTH CONGRESS OF THE REPUBLIC 
) 
OF THE PHILIPPINES 
) 
First Regular Session 
) 
'13 
OCT -2 An :36 
SENA"TJ;;. 
S. No. 
1.763 
RECEIVED BY:"f' 
Introduced by Senator Miriam Defensor Santiago 
EXPLANATORY NOTE 
The offering and operation of health plans is a growing and profitable industry in the 
Philippines. Many organizations are either engaged in this business or subscribe to one. People 
subscribe to these health plans and pay substantial sums for guaranteed access to quality health 
care when they need it. 
One of the critical factors that ensure quality health care is a patienes access to all 
relevant information necessary to make appropriate decisions about their health care. Open 
medical communication between health care providers and their patients is a key to prevention 
and early diagnosis and treatment, as well as to informed consent and quality, cost-effective care, 
therefore open medical communications are in the best interests of patients. It is critical that 
health care providers continue to exercise their best medical, ethical, and moral judgment in 
advising patients without interference from health plans. 
This bill seeks to establish a national standard that protects medical communications 
between health care providers and patients.' 
~'-
4lt..""~J~.~ 
~IRIAM DEF~SOR S 
'f'fA'j~ 
• This bill was Originally filed during the Thirteenth Congress, First Regular Session. 
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SIXTEENTH CONGRESS OF THE REPUBLIC 
) 
OF THE PHILIPPINES 
) 
First Regular Session 
) 
'13 
OCT -2 1\11 :36 
SENAIE 
S. No. 
763 
Introduced by Senator Miriam Defensor Santiago 
AN ACT 
PROTECTING CERTAIN TYPES OF MEDICAL COMMUNICATIONS 
BETWEEN A HEALTH CARE PROVIDER AND A PATIENT 
Be it enacted by the Senate and the House of Representatives of the PhilippInes in 
Congress assembled: 
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SECTION I. Short Title. - This Act shall be known as the "Patient's Right to Know Act." 
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SECTION 2. Definitions of Terms. - For the purposes of this Act, the term: 
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(A) 
"Health Care Provider" means anyone licensed or certified under Philippine law 
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to provide health care services and who is operating within the scope of such license; 
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(B) 
"Health insurance issuer" means any company, corporation, association or 
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organization that offers any policy, contract or agreement that stipulates to provide for the 
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insured either medical attention, medicine, care during disability, or money necessary for any 
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such purposes; and 
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(C) 
"Health plan" means a group health plan and any individual health insurance 
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operated by a health insurance and includes any other health care coverage provided through a 
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private or public entity. In the case of a health plan, that is an employee welfare benefit plan, any 
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third party administrator or other person with responsibility for contracts with health care 
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providers under the plan shall be considered, for purposes of enforcement under this section, to 
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be a health issuer operating such health plan; and 
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(D) 
"Medical communication" means any communication made by a health care 
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provider with a patient of the health care provider or the guardian or legal representative of such 
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patient with respect to: 
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(1) 
The patient's health status, medical care, or legal treatment options; 
(2) 
Any utilization review requirements that may affect treatment options for 
the patient; or 
(3) 
Any financial incentives that may affect the treatment of the patient. 
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The term does not include a communication by a health care provider with a patient of 
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the health care provider or the guardian or legal representative of such patient if the 
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communication involves a knowing or wilful misrepresentation by such provider. 
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SECTION 3. Prohibition of Interference with Certain Medical Communications. -
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(A) 
(B) 
Prohibition. -
(1) 
General Rule. - The provisions of any contract or agreement, or the 
operation of any contract or agreement, between an entity operating a health 
plan (including any partnership, association, or, other organization that enters 
into or administers such a contract or agreement) and a health care provider 
(or group of health care providers) shall not prohibit or restrict the provider 
from engaging in medical communications with his or her patient. 
(2) 
Nullification. - Any contract provision or agreement described in paragraph 
(1) shall be null and void. 
(3) 
Prohibition on Provisions. - Effective on the date described in Section 7, a 
contract or agreement described in paragraph (1) shall not include a 
provision that violates paragraph (1). 
Rules of Construction. -Nothing is this Act shall be construed -
(l) 
To prohibit the enforcement, as part of a contract or agreement to which a 
health care provider is a party, of any mutually agreed upon terms and 
conditions, including terms and conditions requiring a health care provider 
to participate in, and cooperate with, all programs, policies, and procedures 
developed or operated by a health plan to assure, review, or improve the 
quality and effective utilization of health care services, if such utilization is 
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according to the guidelines or protocols that are based on clinical or 
scientific evidence and the professional judgment of the provide, but only if 
the guidelines or protocols under such utilization do not prohibit or restrict 
medical communications between providers and their patients; or 
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(2) 
To permit a health care provider to misrepresent the scope of benefits 
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covered under a health plan or to otherwise require the plan to reimburse 
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providers for benefits not covered under the plan. 
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SECTION 4. Penalty Clause. - An entity operating a health plan in the Philippines that 
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violates Section 3(A) shall be subject to a fine of up to T.wo Hundred Thousand Pesos 
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(P200,OOO.OO) for each such violation. 
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SECTION 5. Separability Clause. - If any provision or part hereof is held invalid or 
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unconstitutional, the remainder of the law or the provision not otherwise affected shall remain 
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valid and subsisting. 
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SECTION 6. Repealing Clause. - Any law, presidential decree or issuance, executive 
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order, letter of instruction, administrative order, rule, or regulation contrary to or inconsistent 
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with the provisions ofthis Act is hereby repealed, modified, or amended accordingly. 
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SECTION 7. Effectivity Clause. - This Act shall take effect fifteen (15) days after its 
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publication in at least two (2) newspapers of general circulation. 
Approved, 
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