Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City
NINETEENTH CONGRESS
First Regular Session
HOUSEBILLNo.    5200
Introduced by:  Hon. Keith  Micah "Atty.  Mike" D.L. Tan
AN ACT
ESTABLISHING APEX HOSPITALS IN  EVERY REGION OF THE COUNTRY AND
PROVIDING FUNDS THEREFOR
EXPLANATORY NOTE
This    bill,    which   was    principally   authored    by    Rep.    Angelina    "Helen"   Tan,
Chairperson  of the  Committee on  Health  during  the  previous  Congress,  was  approved
on final reading by the House of Representatives but was left unacted by the Senate.
It   is   now   being    refiled   consistent   with   Article   11,    Section    15   of   the    1987
Constitution, which provides that "The State shall protect and promote the right to health
of the people and instill health consciousness among them.
Also,  Article  XIIl,  Section  11  states that 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."
The bill seeks to transform  regional  hospitals  in the country into functioning  apex
hospitals and the establishment of new apex hospitals in strategic areas.
Consistent  with   Republic  Act  No.11223,   otherwise  known   as  the  "Universal
health  Care  Act",  which  ensures  that  all  Filipinos  are  guaranteed  equitable  access  to
quality   and   affordable   health   care   goods   and   services,   the   bill   provides   for   the
establishment   and   upgrading   of   regional   hospitals   to   enable   them   with   minimum
functional  capacities  of  apex  hospitals  that  are  at  par  with  international  health  care
institutions that provide quality medical services.
It  also   seeks  to  establish   an   Apex   Hospital   Modernization   Program   for  the
establishment,  development,  and enhancement of the physical facilities, equipment and
instruments, and service delivery of all the apex hospitals.
For these reasons, the swift passage of this bill is earnestly sought.
Keith Micah "Atty. Mike" D.L. Tan
4th  District,  Quezon


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City
NINETEENTH CONGRESS
First Regular Sess.Ion
HOUSE BILL NO.
5an,.LJ
Introduced  by:  Hon. Keith  Micah  "Atty.  Mike"  D.L.  Tan
AN ACT
ESTABLISHING APEX HOSPITALS IN EVERY REGION OF THE COUNTRY AND
PROVIDING FUNDS THEREFOR
B_e  it  enacted  by  the  Senate  and  the  House  of  Representatives  of the  Philippines  .In
Congress assembled:
SECTION  1.  Short title. -This Act shall be known as the "Apex Hospitals Act."
SEC. 2.  Declaration of Policy. -lt is the policy of the State to adopt an integrated
and  comprehensive  approach  to  health  development which  shall  make  health  services
available,  accessible and  affordable for all.  To this end,  reforms  shall  be  introduced  to
the   Philippine   health   delivery  system   to  achieve   universal   health   care  for  Filipinos
through the upgrading  of facilities that shall transform  regional  hospitals  into functioning
apex  hospitals  and  the  establishment  of  new  apex  hospitals  in  strategic  areas  of the
country.
SEC.  3.  Definition of Terms. -As used in this Act:
(a) Anatomic and clinical pathology laboratory system -refers to a facility for the
diagnosis of diseases through  laboratory testing  of blood and other body fluids, tissues,
and the microscopic evaluation  of individual cells.  The  laboratory testing  shall cover the
following areas:
1)   Anatomic   pathology,    which    includes   histopathology,    cytopathology,    and
electron microscopy; and
2)   Clinical   pathology,   which   includes   clinical   microbiology,   clinical   chemistry,
hematology,  blood bank,  and  molecular diagnostics or DNA testing.
(b)  Angiogram  -  refers  to  a  diagnostic  procedure  that  outlines  blood  vessels,
usually arteries,  in various areas in the body to  identify narrowing  of or blockages  in the
arteries in the body;
(c) Apex hospital - refers to an end-referral  hospital offering  specialized services
in  accordance with this Act,  and  is contracted  as a stand-alone facility by the Philippine
Health  Insurance Corporation (PhilHealth);
(d)  Basic emergency care - refers to the  response to a situation  where there  is
urgently  required  medical  care and  attention,  and  shall  include  procedures  required  for
initial diagnosis,  use of equipment and supplies in sufficiently addressing the emergency
situation,  considering the welfare of the  patient.  It also  includes the  necessary medical
procedures and  treatment administered  to a woman  in  active  labor to ensure the safe
delivery of the newborn;
(e)   Computed   tomography   (CT)   scan   -  refers  to   an   X-ray   image  which   is


produced by applying tomography,  a technique wherein a computer controls.the motion
of the X-ray source and  detectors,  and  processes the data to produce the  image.  The
detailed  images  of internal  organs  obtained  by this  type  of sophisticated  X-ray  device
can  reveal  anatomic  details  of internal  organs  that  cannot  be  seen  in  conventional  X-
rays;
(f)  Dialysis - refers to the process of removing waste products and  excess fluid
from the  body.  Dialysis  is  necessary when the  kidneys are  not able to adequately filter
the blood;
(g)  Dialysis facility system - refers to a facility that provides treatment for chronic
kidney disease;
(h)  High  risk  pregnancy  unit  (HRPU)  -  refers  to  a  unit  in  the  hospital  where
women  with  complications  arising  from  pregnancy  are  confined,  and  whose  treatment
requires   constant  supervision   or  further  investigation   and   assessment.   The   unit   is
operated  by  experts  such  as  perinatologists,  obstetricians  and  pediatricians,  with  the
assistance  of other specialists.  It  is  a  fully  equipped  obstetric  intensive  care  unit  (lcu)
that can handle high risk cases including high risk neonates;
(i)  Intensive  care  unit  (lcu)  -  refers  to  a  hospital  unit  where  patients  requiring
close  monitoring,  continuous  attention,  and  intensive  or  critical  care  are  confined.  An
lcu  contains  highly  technical  monitoring  devices  and  equipment with  specially  trained
personnel on critical care;
¢)  Magnetic resonance imaging  (MRl) -refers to a procedure that uses a strong
magnetic field  and  radio  waves  to  capture  detailed  images  of the  organs  and  tissues
within the body;
(k)   Mammogram  -  refers  to  an  X-ray  test  to  visualize  normal  and  abnormal
structures within the breasts;
(I)  Medical  specialist  -  refers  to  a  doctor  of  medicine  that  practices  and  has
expertise on a specific branch of medicine;
(in)  Neonatal  intensive  care  unit  (NICU)  -  refers  to  a  hospital  unit  containing  a
variety of mechanical  devices and  special  equipment for the  care  and  management of
premature   or  preterm   and   seriously   ill   newborn   babies.   The   unit   is   comprised   of
neonatologists,   pediatric   subspecialists,   and   nurses   who   are   highly   trained   in   the
management of medical and surgical conditions of the newborn;
(n) Regional government hospital -refers to a hospital operated and  maintained,
either  partially  or  wholly,  by  the  national  government  or  by  any  department,  division,
board or other agency thereof; and
(o)  Rehabilitation care facility system - refers to a hospital facility that provides a
specialized   medical   care   and/or   rehabilitation   services   to   injured,   sick   or  disabled
patients, which includes speech therapy and physical rehabilitation.
SEC.  4.  Coverage.  -  This  Act  shall  apply  to  regional  hospitals  whose  service
capacities  are  as  general  hospitals  with  at  least  five  hundred  (500)  beds,  and  which
have been identified by the Department of Health (DOH) to have full potential to operate
as apex hospitals based on the Philippine Health  Facility Development Plan (PHFDP).
The  DOH  may establish  new apex  hospitals  in  strategic areas  in  the  country  in
accordance  with  the  PHFDP,  and  subject  to  the  requirements  of  Sections  5  and  6
hereof.


SEC.  5.  Apex  Hospital  Modernization  Program.  -Within  five  (5)  years  from  the
effectivity  of  this  Act,  all  the  DOH  regional  hospitals  described  in  Section  4  shall  be
upgraded  or established,  to  have  minimum  functional  capacities  of apex. hospitals that
are at par with international health care institutions that provide quality medical services.
To  achieve  this  goal,  there  shall  be  an  Apex  Hospital  Modernization  Program  for  the
establishment,  development,  and enhancement of the physical facilities, equipment and
instruments, and service delivery of all the apex hospitals,  including the following:
a)  Physical  Facilities,   Equipment  and   Instruments.  -  At  the  minimum,  all  apex
hospitals  shall  operate  and  maintain  the following  physical  facilities,  complete with  the
necessary equipment and instruments including:
1. Ambulatory Surgical Clinic;
2. Anatomic and Clinical Laboratory;
3.  Blood Station;
4.  Dialysis  Facility;
5. General  Intensive Care Unit;
6.  High  Risk Pregnancy Unit;
7.  Isolation  Facilities;
8.  Neonatal  Intensive Care Unit;
9.  Nuclear Medicine  Facility;
10.  Physical  Medicine and  Rehabilitation  Facility;
11.  Psychiatry Facility;
12.Radiologic Facilities such as X-Ray,  CT Scan,  Mammogram,  MRl,  ECG,
Angiogram,  Ultrasound and others;
13.  Surgical  Facility and  Maternity Facility;  and
14.  Other necessary medical facilities as may be identified  by the DOH.
All  the  facilities  enumerated  herein  shall  have  competent  and  trained  nurses,
therapists,  medical technicians and other ancillary and support staff.
b)  Service  Delivery.  -  All  apex  hospitals  shall  offer  the  services  for  all  kinds  of
illnesses,  diseases,  injuries  or  deformities.  It  shall  have  certified  and  eligible  medical
specialists   to   facilitate   timely,   efficient,   affordable,   and   accessible   diagnosis   and
treatment for the following areas:
1.  Clinical Services
a.  Family Medicine;
b.  Internal  Medicine;
c. Obstetrics and Gynecology;
d.  Pediatrics; and,
e.  Surgery.
2.  Basic Emergency Care Services
3. At least one medical specialist on any of the following areas, to be determined
by the DOH based on the burden of disease in the region:
a.  Cardiology;
b.  Neurology;
c.  Oncology;
d.  Pathology;
e.  Pulmonology;
f.  Psychiatry;
9.  Rehabilitation  Medicine;


h.  Urology;  and
i. Other specialists as determined by the DOH.
c) Teaching and training  hospital. Within three (3) years from the effectivity of this
Act,   all   apex   hospitals   shall   be  expanded   as  teaching   and   training   hospitals  with
accredited  residency  training  programs  for  physicians  in  the  four  (4)  major specialties
namely,  Medicine,  Pediatrics, Obstetrics and Gynecology, and Surgery.
The secretary of the DOH shall determine the additional positions required for the
purpose in accordance with the revised compensation and position classification system
subject to the  evaluation  and  approval  of the  Department of Budget and  Management
and  in compliance with the civil service laws,  rules and  regulations.
SEC. 6.  Inventory and Audit of Hospitals. -An  inventory and audit of the physical
facilities,  equipment and  instruments,  as well as the personnel of the regional hospitals,
shall  be conducted within  one  hundred  eighty (180) days from the effectivity of this Act,
to  determine  the  present  classification  of  the  respective  regional  hospitals  based  on
their functional  capacity.  The  result of the  inventory and  audit shall  be the  basis  of the
modernization plan for each apex hospital. The establishment of apex hospitals shall be
prioritized in areas where they are most needed.
The  DOH  shall conduct an  annual  inventory and  audit of apex hospitals for their
continuous development and  to determine the  need  to establish  new ones,  in  line with
the Apex Hospital Modernization Program.
SEC.  7. Annual  Report. -Two (2) years from the effectivity of this Act and every
year   thereafter,   the   DOH   shall   submit   an   annual   report   on   the   Apex   Hospital
Modernization  Program  to the  Congress  of the  Philippines,  through  the  Committee  on
Health of the House of Representatives and the Committee on  Health and  Demography
of the Philippine Senate.
SEC.  8.  Appropriations.  -  The  initial  amount  for the  implementation  of this  Act
shall  be  charged  against  the  current  year's  appropriation  of the  DOH.  Thereafter,  the
funding of which shall be included  in the annual General Appropriations Act.
SEC.  9.  Implementing  Rules and  Regulations. -The Secretary of the  DOH shall
issue the  necessary rules  and  regulations within  ninety (90) days after the effectivity of
this Act.
SEC.   10.   Separability   clause.   -   If  any   provision   of  this   Act   shall   be   held
unconstitutional or invalid,  the remaining  provisions which  are not affected thereby shall
continue to be in full force and effect.
SEC.11.   Repealing  Clause.  -All  laws,  decrees,  executive  orders,   rules  and
regulations,  and  other  issuances,  or  parts  thereof,  contrary to  or  inconsistent with  this
Act are hereby modified, amended or repealed accordingly.
SEC.   12.   Effectivity.   -This  Act   shall   take   effect  fifteen   (15)   days   after  its
publication in the Official Gazette or in a newspaper of general circulation.
Approved,