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Republic of the Philippines
House of Representatives
Queson City, Meteo Manila

Eighteenth Congress

First Regular Session

House Bill No, 2849

Introduced by

HON. ANNA MARIE VILLARAZA-SUAREZ and
HON. DAVID C. SUAREZ

EXPLANATORY NOTE

On February 20, 2019, President Duterte signed into law Republic Act No.
11223, or the ‘Universal Health Care Law’, automatically enrolling all Filipino
citizens in the National’ Health Insurance Program (NHIP) and giving them access to
the full continuum of health services they need, without or less of the
accompanying financial burden, thus guaranteeing equitable access to quality and
affordable health care services for all Filipinos. However, since the health benefits
Packages are still determined by the Philippine Health Corporation (PhilHealth),
circumstances may still emerge when out-of-pocket expenditures will arise if the
benefit packages are not enough to cover the actual medical needs of indigent and
Poor patients.

Currently, the Department of Health (DOH) is implementing its Medical
Assistance Program (MAP) thru all DOH and Local Government Unit (LGU)
administered hospitals to assist patients who are in most need, including walk-in
Patients. The Department of Social Welfare and Development (DSWD) for its part
has its Assistance to Individuals in Crisis Situation (AICS) program which provides
integrated services such as immediate rescue and protection, provision of direct
financial and material assistance, and referrals for medical, legal, psychosocial,
temporary shelter, and other services to indigent clients. The Philippine Charity


Sweepstakes Office (PCSO) has a similar Program (Individual Medical Assistance
Program or IMAP) which provides financial assistance to individuals with health-
related problems. The PCSO assumes the obligation of a specific amount due from
the client for the services rendered. Indigent and poor patients who are saddled
with out-of-pocket balances from PhilHealth coverage often rely on these other
Public health programs to fill in the gap.

Availment of the benefits from these public health programs by indigent or
poor patients or by their relatives entail not only time and effort, but actual costs
on transportation and food occasioned by the need to travel from their distant
places of residence.

This bill seeks to establish *Malasakit Centers’ in all public hospitals
administered by the DOH, LGUs or State University or College (SUC), or by the
Department of National Defense (DND), as the case may be, which will house desk
representatives from PhilHealth, DOH and DSWD. The Malasakit Centers, which
shall be established and administered by PhilHealth in coordination with DOH and
DSWD, will serve as a one-stop shop for indigent or poor Filipinos who are in need
of medical assistance and other related social services with the objective of
covering or reducing their out-of-pocket expenditures, and minimizing
transportation and other costs incidental to the availment of the services needed. In
this manner, the delivery of basic services to the people is made more efficient,
responsive and sustainable.

For the foregoing reasons, the immediate consideration and approval of this
bill is earnestly urged.

HON. ANNA MARIE ‘mld “SUAREZ

REPRESENTATIVE
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Republic of the Philippines
House of Representatives
Queson City, Metro Manila

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Eighteenth Congress

First Regular Session
2849

Introduced by

HON. ANNA MARIE VILLARAZA-SUAREZ and
HON. DAVID C. SUAREZ

AN ACT
PROVIDING FOR THE ESTABLISHMENT OF * MALASAKIT CENTERS’
IN ALL DEPARTMENT OF HEALTH-, LOCAL GOVERNMENT UNIT-,
STATE UNIVERSITY AND. COLLEGE-, AND DEPARTMENT OF NATIONAL
DEFENSE-HOSPITALS IN THE COUNTRY TO COMPLEMENT THE
IMPLEMENTATION OF REPUBLIC ACT NO. 11223, OTHERWISE
KNOWN AS THE ‘UNIVERSAL HEALTH CARE ACT’,
PROVIDING FUNDS THEREFOR, AND FOR OTHER PURPOSES

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 ‘Malasakit Centers Act’
of 2019"

SECTION 2. Declaration of Policies - It is the declared policy of the State to
improve the delivery of health care services to the people, and to ensure financial
assistance for hospital and medical expenses are available and accessible to the
people.


Republic Act No. 7610 or the ‘Special Protection of Children Against
Abuse, Exploitation and Discrimination Act’;

2) Patients with catastrophic illness or any iliness as a primary
Condition that is life or limb-threatening and requires prolonged
hospitalization, extremely expensive therapies or other special but
essential care that would deplete one's financial resources, unless
covered by special health funding policies;

3) Unemployed or without gainful employment;

4) Suspected or confirmed victims of torture as defined by Republic
Act No. 9745 or the ‘Anti-Torture Act of 2009’;

5) Soldiers and police officers rendered disabled to be gainfully
employed and their dependents, and dependents of soldiers and
police killed in action;

6) Rebel returnees, prisoners of war and their dependents;

7) Victims of calamities or disasters such as but not limited to
typhoons, earthquake, whose place of residence are officially under
a state of emergency or calamity,

(j) State University and College (SUC)- Hospital refers to hospitals managed
by State Universities and Colleges.

SECTION 4. Malasakit Centers - To complement the implementation of
Republic Act No. 11223, otherwise known as the ‘Universal Health Care Act’, there

regarding coverage, billing, health benefits packages, patient navigation and
referral to the health care provider network, and (b) one-stop shop medical
assistance to cover out-of-pocket medical expenses of indigent and Poor patients.

1) The Philhealth representative shall be in charge of the over-all operation
of the Malasakit Center. He/she shall assist and process the concerns of
both direct and indirect contributors to Philhealth regarding the
implementation of Republic Act No. 11223, including but not limited to
coverage, billing, health benefits packages, and financial concerns. The
Philhealth representative shall also assist in Patient navigation and
referral to the health care provider network;


SECTION 3. Definition of Terms - For purposes of this Act, the following terms
shall mean:

(a)

(b)

(c)

(4)

(e)

(fy

(9)

(h)

10)

Department of Health (DOH)-Hospital refers to a hospital under the
management and administration of the Department of Health (DOH),
including the four (4) corporate hospitals under the Secretary of Health,
namely: Philippine Heart Center, Lung Center of the Philippines, National
Kidney and Transplant Institute and the Philippine Children's Medical
Center;

Department. of National Defense (DND)-Hospital refers to a hospital
managed by the Department of National Defense;

Financial Assistance or Material Assistance refers to actual cash or check
which covers burial, transportation, and other allied assistance given by
agencies as mandated by existing laws, rules and regulations to Provide
such assistance;

Indigent patient refers to patient who has no visible means of income, or
whose income is insufficient for the subsistence of his/her family, as
identified by the Department of Social Welfare and Development
(DSWD), Local Government Unit (LGU) social worker or the medical
social worker of the health facility;

Local Government Unit (LGU)-Hospital refers to a hospital managed by
the local government units, usually the provincial government;

Malasakit Center refers to a processing center for Philhealth and one-
stop shop for Filipinos in need of medical assistance;

Medical/Assistance refers to assistance for out-of-pocket expenditure in
the form of coupon, stub, guaranty letter, Promissory note or voucher
that has monetary value, given directly to individual recipients or
beneficiaries to address their immediate needs;

Out-of-pocket expenditure refers to medical and surgical services not
currently paid for or sufficiently reimbursed by PhilHealth under Republic
Act No. 11223 or the Universal Health Care Act, or other financing
sources;

Poor Patient refers to those not classified as indigent but are otherwise
considered poor or with financial difficulty to access adequate medical
care and/or pay hospital bills because of certain unavoidable
circumstance, such as but not limited to:

1) Senior citizens, persons with disability (PWD), orphans, abused
women and children as defined by Republic Act No. 9262 or the
‘Anti-Violence Against Women and Their Children Act of 2004’, and




2) The DOH repfesentative shall be in charge of providing medical assistance
to indigent and poor patients; and,

3) The DSWD representative shall be in charge of providing financial or
direct assistance to indigent poor patients.

SECTION 5. Provision of Medical Assistance - The DOH shall provide medical
assistance to indigent and poor patients through the Malasakit Center which shall
be charged from the annual appropriation of the DOH for assistance to indigent

patients. The DOH may also augment medical assistance using the following
sources:

a) Other appropriations earmarked by national government agencies and
local government units purposely for medical assistance to indigent and
Poor patients: Provided, that appropriations earmarked for a specific
hospital shall only be used for that specific hospital; and

b)

Donations and grants-in-aid: Provided, that donations and grants donated
for a specific hospital shall only be used for that specific hospital:
Provided further, that the donations granted shall only be used for the
Purpose specified by the donor.

The DOH shall issue guidelines for the proper implementation of the medical
assistance to indigent and poor patients which shall include order of charging from
the aforementioned sources of financing, availment procedures, transfer and

release of funds, recording and reporting, monitoring and evaluation, partnerships
with private hospitals, among others.

The DOH shall make a quarterly report to the Office of the President and Congress
regarding the expenditures or disbursement of the medical assistance to indigent
and poor patients.

SECTION 6. Medical Assistance - The Medical Assistance shall cover for
medical and surgical services not currently paid for or sufficiently reimbursed by
PhilHealth in accordance with Republic Act No. 11223 or other financing sources,
and shall be used for the following drugs, medicines, goods and other services
prescribed by the physician of the health facility such as but not limited to:

a) Laboratory, imaging and all other diagnostic procedures;

b) Drugs and medicines included in the Philippine National Drug Formulary,
including exémptions to be cleared by Pharmaceutical Division of the
DOH;

©) Supplies, orthopedic/assistive devices, prosthesis, blood and blood
products;


4) Dental services, except those that are for aesthetic purpose and not
medically indicated;

€) All clinically indicated medical and surgical Procedures, whether
emergency or elective;

f)

Prescribed post-hospitalization rehabilitation services, aftercare Program,
appropriate mental and psychological Support, including those done on an
outpatient basis;

9) In case of non-availability of clinically indicated drugs, medicines, tests,
Services or procedures in government health facilities, the concerned
government health facility may enter into contract with DOH-accredited
Private health facility to provide the needed drug, test, service or
Procedure to the patient, charged against the DOH hospital;

hy

All hospital bills including professional fees, provided that the expenses
for professional fees shall not exceed fifty percent (50%) of the approved
assistance; and

i) All other medical, health, documentary and related services billed by the
hospital.

Provided, that medical assistance to patients shall be based on need as
recommended by the medical social worker and attending physician, approved by
the Chief of Hospital/Medical Director of the institution involved and DOH authorized
Officials, subject to availability of funds.

SECTION 7. Provision of Financial Assistance - The DSWD shall provide
financial assistance through the Malasakit Center to indigent and poor patients,
individuals in emergency situations, under distress or are in need of supplemental
financial support due to health or medical conditions, sickness or disease; funeral
and burial concerns, which also includes the most direct. and economiccl
transportation expense to or from place of residence or specific destination.

The provision of financial assistance through Malasakit Centers shall be charged to
the annual appropriation of the DSWD for assistance to individuals and families in

SECTION 8. Establishment of Malasakit Centers - The Philhealth and DOH,
and DSWD shall, in the establishment of the Malasakit Centers, undertake
consultations with all DOH, LGU, DND and SUC hospitals; Provided, That in the
establishment of the Malasakit Centers, highest priority shall be given to those
economically-depressed areas or provinces.

Within three (3) years from the effectivity of this Act, the Philhealth and DOH shall
establish Malasakit Centers down to the Primary and Secondary Care levels to help


facilitate the adoption of appropriate health-seeking behaviors, assist primary care
Providers in encouraging medical consultation at the health centers, monitor patient
compliance, and ensure proper patient referral and availment of benefits.

Private hospitals are hereby encouraged to establish Malasakit Centers. The
Philhealth and DOH, and DSWD may enter into a Memorandum of Agreement with
Private hospitals for the establishment of Malasakit Centers which shall cater to
indigent and poor patients of the private hospital.

SECTION 9. Donations from Non-Governmental Organizations and the
Private Sector - The DOH may solicit and receive donations from the private
sector for medical assistance to indigent and poor patients. Such donations shall be
exempt from income or donor's tax and all other taxes, fees and charges imposed
by the government: Provided, that donations from the private sector for a particular
hospital shall only be used for the benefit of the patients of the particular hospital:
Provided further, That the donations and grants shall only be used for the purpose
specified by the donor.

Receipts from donations, whether in cash or in kind, shall be accounted for in the
books of the DOH in accordance with accounting and auditing rules and regulations.
The receipts from cash donations and proceeds from sale of donated commodities
shall be deposited with the National Treasury and recorded as a special account in
the General Fund and shall be available to the DOH through a special budget
Pursuant to Section 35, Chapter 5, Book VI of Executive Order No. 292. Donations
with a term not exceeding one (1) year shall be treated as trust receipts.

The DOH shall submit the quarterly reports of all donations received, whether in
cash or in kind, and expenditures or disbursements thereon with electronic
signature to the DBM, through the Unified Reporting System, and to the Speaker of
the House of Representatives, the President of the Senate. of the Philippines, the
House Committee on Appropriations, the Senate Committee on Finance and the
‘Commission on Audit, by posting such reports on the DOH website for a period of
three (3) years. The head of the DOH shall send written notice to the said offices
when said reports have been Posted on its website which shall be considered the
date of submission.

SECTION 10. Appropriations. - The amount necessary to establish Malasakit
Centers shall be included in the General Appropriations Act. Additionally, there shall
be an annual appropriation for the assistance to indigent patients under the DOH
specifically for medical assistance to indigent and poor patients as Provided for in
Section 5 of this Act, and an annual appropriation for assistance to individuals and
families in difficult circumstances under the DSWD budget for financial assistance to
indigent and poor patients as provided for in Section 7 of this Act.

SECTION 11. Implementing Rules and Regulations. - Within ninety (90) days
from the approval of this Act, Philhealth, DOH, and DSWD, in coordination with
Department of Interior and Local Government shall jointly issue the implementing
rules and regulations of this Act.


SECTION 12. Separability Clause. - Any portion or provision Of this Act that is
declared unconstitutional shall not have the effect of nullifying other Portions or
Provisions hereof as long as such remaining portions can still subsist and be given
effect in their entirety.

SECTION 13. Repealing Clause - Al laws, ordinances, rules, regulations, other
issuances or Parts thereof, which are inconsistent with this Act, are hereby repealed
or modified accordingly.

SECTION 14. Effectivity. - This Act shall take effect fifteen (15) days after its
Publication in the Official Gazette or ina Newspaper of general circulation.