THIRTEENTH CONGRESS OF THE REPUBLIC) 
OF THE PHILIPPMES 
1 
First Regular Session 
1 
S. B. sENATE263 
No. 
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The offering and operkon.of 
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health plans i 
growing ani profi 
the Philippines. Many organiqtions are either engaged in this business or sub 
People subscribe to these health plans and .pay substantial, . .  
sums for guqh 
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s that'ensure:.quality 
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fopriate decisions about the 
medical conmnnication between health care providers and their p 
prevention and early diagnosis 
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 and keatment, as well ag to informed 
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cost-effective care, therefore open medical commnnications are in the 
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paiients. It is critical tliai liealth care providers continue to exercise, their, best ,medical,, ,,_. . 
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ethical, and nioral judgment, in advising patients without i 
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THIRTEENTH'CONGRESS 
OF THE wruBLIc) 
First Regular Session 
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OF THE PHILIPPINES , 
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6 I+&o.BY: 
SEN A T 2 2 6 5  
S. B. No. 
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Introduced by Senator Miriam Defensor Santiago 
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AN ACT 
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TO PRoHIBlT THE RESTRICTION OF CERTAIN TYPES OF MEDIC&,: 
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" COMMUNICATIONS BETWEEN A W , T H  CARE PRQVIDEJR AM) 
A P A m .  
Be it enacted by tfie Senate and House of Representatives of the Philippines in Congvess 
assembled, 
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SECTION 1. Short Title. - This Act shall be known as the "Patient's Right to 
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Know Act." 
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SECTION 2; DeJiniti6ns. - For the purposes of this Act- 
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(l).-HE&TE:~ARE 
'PROVIDW- means anyone licensed 'or certified 
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under Philippine law to providehealth,sare services and who is operating within the scope 
of such license; 
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(2) &TH,'~NSURANCE ISSUER- means any company, corporation, 
association or organiiatiofi that bffers any policy, contract or agreement that ttipulatek to 
provide for the inmired either medical attention, medicine, care during disability, or money 
necessary for any such pmposes; 
(3) HEALTH PLAN- means a group health plan and any individual health 
insnrance operated by a health insurance issuer and includes any other heaith care 
coverage provided through aprivate or public entity. In the case of a health plan, that is an 
employee welfare benefit p
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any' third parly adminish-ator or other person:with 
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responsibility for contracts with health car6 providers under the plan shall be 
for purposes of enforcement under this section, to be a health insuran 
such health plan; 
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(4) MEDICAL COMMUNICATION- 
(A) IN GENERAL- The term 'medical communication' means any 
communication made by a health care provider with a patient of the health care provider 
(or the guardian or legal representative of such palient) with respect to- 
(i) the patient's healthstatus, medical care; or legal treatment options; 
(ii) any utilization review requirements that may &ect treatment 
options for the patient; or 
(iii)any financial incentives that may affect the treatment of the patient. 
(B) MISREPRESENTATION- "lie term 'medical communication' does not 
include a communication by aliealth care provider with a patient of the health 
care provider (or the gnardian or legal representative of such patient) if the 
communication involves a knowing or willfbl misrepresentation by such 
provider. 
SECTION 3. 
Prohibition 
Of 
Interference 
With 
Certain Medical 
Communicationx- 
(A) PROHIBlTION-- 
(1) G- 
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 goup of health care providers) shall 
not prohibit or resh-ict the provider from engaging in medical communications with his or 
her patient. 
(2) IWLLmCAnON- Any conhct 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). 


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{B) RULES OF CONSTRUCTION- Nothing in this Act slid1 be constrned- 
(1) to prohibit the enforcement, ag part of a conlract or agreement to which a heallh 
care provider is apaty, of any mutually w e e d  upon terms and conditions, including term 
and conditions requiring a health care provider to participate in, and cooperate with, all 
programs, policies, and procedima developed or operated by a health plan to asswe, 
review, .or improve the quality and effective utilization of health care services (if such 
utilization is according to guidelines or protocols that are based on clinical or scientific 
evidence and the profeseional judgment of the provider) but only if the guidelines or 
protocols under such utilization do not prohibit or restrict medical communications 
between providers and their patients; or 
(2) to permit a health care provider to misrepresent the scope of benefits covered 
under a health plan or to otherwise require the plan to reimburse providers for benefits not 
covered under the plan 
SECTION 4. PenaEty Clause. - An entity operating a health plan in the Philippines 
that violates Section 3(a) shall be subject to a fine of up to Two Hundred Thousand Pesos 
(P200,OOO) for each such violation. 
SECTION 5. Sepnrability Clause. - If any provision or part hereof, is held invalid 
or unconstitutional, the remainder of the law or the provision not otherwise @ected shall 
remain valid and subsisting. 
SECTION 6. Repenling Clause. - Any law, presidential decree or issuance, 
executive order, letter of instruction, administrative order, rule or regulation contraty to or 
inconsistent wiih, the provision of this Act is hereby repealed, modified or amended 
accordingly. 
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SECTION 7. Eflecffvity Claim. - This Act yhall take effect fifteen (15) days after 
its publication in at least two (2) newspapers ofgenerd circulation. 
Approved. 
MJS 
7/17/98