< 
THIRTEENTH CONGRESS OF THE 
1 
Fir st Regular Session 
1 
*04 Jut4 363 PI0 :? 
3 
REPUBLIC OF THE PHILIPPINES 
) 
Senate Bill No. 
.liim 
i . I  
Introduced by: Senator Franklin M. Drilon 
EXPLANATORY NOTE 
In the past decade, Rehabilitation Medicine as a specialty has 
experienced growth in all aspects. The number of trainees, graduates, 
and certified diplomats and fellows has increased tremendously. 
. 
I 
Alarming, however, is the fast pace at which rehabilitation centers 
have sprouted throughout the country, all with the noble intent of 
delivering expert rehabilitative 
care to Filipinos suffering from 
neuromusculoskeletal, cardiovascular, pulmonary, and other system 
disorders 
which 
produce 
temporary 
or 
permanent 
disability. 
Unfortunately, not all these rehabilitation centers are rendering what 
they purport to render. 
Moreover, many of these rehabilitation centers are not headed by 
physiatrist (a medical specialist who has trained a minimum of 3 years in 
Rehabilitation Medicine) but by other medical and allied health 
professionals. By the nature of their training, physiatrists are in the best 
position to head rehabilitation centers and supervise the allied 
rehabilitative professionals: physical therapist, occupational therapists, 
speech therapist, orthotists, and prosthetists, 
In the medical field, it is physiatrist who is the specialist in medical 
rehabilitation and who is thus tasked to evaluate and treat patients with 
physical disabilities from the rehabilitation standpoint, and to manage 
and administer Rehabilitation Medicine departments, center, clinics or 
other similar facilities. 
It is the objective of the proposed Rehabilitation Medicine Standard 
Act to set standards for the training and practice of Rehabilitation 
Medicine and set technical and operational standards for rehabilitation 
centers which will function at the highest level of standard and be 
headed and supervised by duly trained and certified physiatrists (medical 
specialists in rehabilitation medicine) and thereby protect the interest of 
the Filipino patients who seek treatment from these centers. 
. 
In view of the foregoing, immediate approval of this bill is earnestly 
sought. 
FRA 


THIRTEENTH CONGRESS OF THE 
1 
Fir st Re gular Session 
1 
'04 
JUN 30 p70:13 
REPUBLIC OF THE PHILIPPINES 
) 
Senate Bill No. 109 
Senate Bill No. 109 
Introduced by: Senator Franklin M. Drilon 
AN ACT PROVIDING FOR THE STANDARD FOR THE 
PRACTICE OF REHABILITATION MEDICINE AND FOR 
OTHER PURPOSES 
Be in 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 "Medical 
Rehabilitation Standards Act of 2004" 
. .  
Section 2. Declaration of Policy. - It is the policy of the State to 
protect and promote the right to health of the people by an accessible 
delivery of expert rehabilitative care to Filipinos suffering from 
neuromusculoskeletal, cardiovascular, pulmonary and other system 
disorders which produce temporary or permanent disability. This shall 
be realized by standardizing the practice of Rehabilitation Medicine and 
standardizing the establishment, management and operational aspects of 
rehabilitation facilities. 
Section 3. Definitions. - As used in this Act, the following terms shall 
mean: 
a. Rehabilitation Medicine - the branch of medicine which deals with 
. 
the prevention, diagnosis, treatment and rehabilitation of 
neuromusculoskeletal, cardiovascular, pulmonary and other 
system disorders which produce temporary or permanent disability 
in patients as well as the performance of different diagnostic 
procedures, including, but not limited to, electromyography and 
other electrodiagnostic techniques. It also involves specialized 
medical care and training of patients with loss of function so that 
1 


s/he may obtain his/ her maximum potential, 
physically, 
psychologically, social and vocationally with special attention to 
prevent unnecessary complications or deterioration and to assist in 
physiologic adaptation to disability. In addition, the practice of 
Rehabilitation Medicine uses agents such as heat, light, water, 
electricity, therapeutic exercise and mechanical agents in its 
treatment armamentarium. 
b. Medical Rehabilitation - the process of helping a person to reach 
the fullest physical, psychological, social, vocational, avocational 
and educational potential consistent with his or her physiologic or 
anatomic impairment, environmental limitation and life plans. 
c. Physiatrist - a physician who is licensed and duly registered with 
the Professional Regulation Commission and who has completed 
three years of residency training in Rehabilitation Medicine in a 
Philippine 
Board Rehabilitation 
Medicine-accredited training 
institution. 
d. Philippine Board of Rehabilitation Medicine (PBRM) - a non-stock, 
non-profit corporation, duly recognized by the Professional 
Regulation Commission and the Philippine Medical Association, 
composed of Board Certified Rehabilitation Medicine Specialists 
tasked with accrediting and evaluating training institutions with a 
specialty in Rehabilitation Medicine, and certif~ng graduates of 
these training programs. 
e. Rehabilitation Medicine Practitioner/ Physiatrist - a licensed 
physician who has completed a residency training program in 
Rehabilitation Medicine in a Philippine Board of Rehabilitation 
Medicine (PBRM) accredited training institution. They shall be 
qualified by the PBRM as: 
A) Board Eligible Physiatrist - refers to those who have 
. 
completed the residency training in a PBRM-accredited 
residency training program but who have not successfully 
completed the specialty board examination. 
B) Board Certified (Diplomate) - refers to those who have 
passed Part I (written) and Part I1 (oral) of the Diplomate 
Board Examination given by the Philippine Board of 
Rehabilitation Medicine (PBRM) . 
2 


f. Rehabilitation Medicine Center/ Facility/ Unit - any facility that 
renders services for the rehabilitation of physical disabilities. This 
may be hospital-based or free standing. 
g. Rehabilitation Medicine Team - a group of medical and allied 
, 
health professionals concerned with the medical rehabilitation of 
patients with physical disabilities. The team is headed by a 
physiatrist and is composed of, but not limited to, the following: 
1. 
Physical Therapists 
2. 
Occupational Therapists 
3. 
Prosthetists And Orthotists 
4. 
Rehabilitation Nurses 
5. 
Speech Pathologists 
6. 
Social Workers 
7. 
Vocational Counselors 
8. 
Recreational Therapists 
Section 4. Scope of Practice. - The practice of Rehabilitation 
Medicine includes: 
a. Professional services related to the care of an individual patient, 
either as a physician primarily responsible for individual patient 
care or as a consultant to another physician namely: 
1. History 
taking, 
examination 
of 
patients 
and/or 
performance 
of 
specific diagnostic procedures for 
purposes of establishing diagnosis and/ or evaluation of 
disability, impairment, functional capacity and potential 
for rehabilitation; 
2. Prescription and/ or rendering of appropriate medical 
treatment which may include any or all aspects of 
physical medicine as well as rehabilitative measures, 
including 
but 
not 
limited 
to 
physical 
therapy, 
occupational therapy, speech therapy and orthotic and 
prosthetic services; 
3. Follow-up examination of patients in offices, hospitals, 
rehabilitation facilities, extended care facilities or home 
for purposes of reevaluation and treatment modifications; 
4. Appropriate consultation with other medical specialists; 
3 


5. Counseling and conference with non-physician health 
care professionals or family concerning conduct of 
patient’s care or patient’s progress; and 
8 ,  
6. Examination of patient’s records, preparation of reports 
Designing/ planning/ implementing of health programs for 
maintenance of health and prevention of disability; 
and correspondence, appearance in testimony pertaining 
. 
to patient. 
b. Professional 
services 
related 
to 
the 
administration of 
rehabilitation facilities or units, namely: 
1. Professional general supervision of rehabilitation services 
in a hospital-based rehabilitation center or unit or any 
other 
free 
standing 
units 
that 
render 
limited 
rehabilitation services, convalescent home and private 
homes, for quality assurance and appropriate utilization 
of services; 
2. Planning, establishment and management of facilities, 
equipment and personnel for functions and activities for 
rehabilitation department or unit, or any other free 
standing unit that render limited rehabilitation services, 
convalescent home and private homes, for quality 
assurance and appropriate utilization of services; 
3. Maintenance of adequate records and statistics; 
4. Education 
of 
physicians 
and 
allied 
health 
care 
professionals in Rehabilitation Medicine; 
both local and abroad, for programs related to 
Rehabilitation Medicine; 
10. 
Promotion of the team approach among medical and 
allied medical health care professionals in the holistic 
care of patients; 
4 


1 I. Setting standards for compensation of Rehabilitation 
medicine services rendered. 
c. 'Guidelines for Practice in a Rehabilitation Medicine Facility: 
1. 
. .  
2. 
3. 
4. 
5. 
6. 
7. 
Every patient shall be examined and diagnosed by a 
physiatrist. The physiatrist recommends, prescribes and 
supervises an individual treatment plan. The treatment 
plan and rehabilitation program shall be regularly 
reviewed on a team basis. 
Medications and various other therapies 
shall be 
prescribed by a physiatrist. 
The physiatrist has the primary responsibility of regularly 
following patients in his charge and modifying or 
terminating treatment. 
A physiatrist shall head the facility/unit and shall 
supervise the delivery of rehabilitation medicine services 
rendered by other members of the Rehabilitation Medicine 
team. In areas where there is no physiatrist, a licensed 
physician shall head the facility or unit. 
If a physiatrist is not competent to manage a patient, he 
shall consult or refer to another physiatrist or physician 
specialist who is competent in the particular disease or 
condition he is treating. 
A Board Certified physiatrist may head not more than 
three (3) Rehabilitation Medicine facilities. In the absence 
of a Board Certified physiatrist, a Board eligible 
physiatrist may head the facility, provided that he 
conforms with the requirements of the PBRM. 
The physiatrist shall charge professional 
fees in 
accordance with the standards of the Philippine Medical 
Association and the Philippine Health Insurance System 
(PHILHEALTH). 
8. The physiatrist shall conduct himself in a manner 
consistent with the Code of Ethics of the Philippine 
Medical Association. 
5 


Section 5. Qualifications to Practice. - A physician is qualified to 
practice Rehabilitation Medicine if s/ he is a Board Certified/ Board 
Eligible physiatrist who is of good moral character and is a member of 
the Philippine Medical Association. 
Section 6. Accreditation and Certification. - This Act aims to 
. 
establish the standards for the practice, 
and certification 
of 
Rehabilitation Medicine practitioners in order to ensure the highest 
quality of professional rehabilitation service to the public and to the 
medical community. 
a. Accreditation of the Physiatrist 
1. The Rehabilitation Medicine Practitioner is a graduate of a 
Philippine Board of Rehabilitation Medicine (PBRM) - 
accredited Rehabilitation Medicine training institution and 
certified by the PBRM as: 
1 a. Board certified (Diplomate) 
1. b Board Eligible 
2. A Rehabilitation Medicine Practitioner is duly recognized as 
PBRM Board Certified upon compliance with and/or 
. 
submission of the following requirements: 
2 .a Authenticated 
Professional 
Regulation 
Commission 
(PRC) ID as duly registered physician. 
2.6 Certificate of completion of training in a PBRM- 
accredited Rehabilitation Medicine training institution. 
2 
~ c Certificate from the Philippine Board of Rehabilitation 
Medicine (PBRM). 
3. A Rehabilitation Medicine Practitioner is duly recognized as 
PBRM 
Board Eligible upon compliance with and/ or 
submission of the following requirements: 
3. a Authenticated 
Professional 
Regulation 
Commission 
(PRC) ID as duly registered physician. 
3.b Certificate of completion of training in a PBRM- 
accredited Rehabilitation Medicine training institution. 
3.c Certificate of eligibility from PBRM 
4. A .  Rehabilitation 
Medicine Practitioner, who. is duly 
recognized as PBRM Board Eligible, must upgrade himself to 
PBRM Board Certified status within five (5) years after 
6 


graduation from a PBRM-accredited Rehabilitation Medicine 
training institution. Forfeiture of this Board eligibility status 
is incumbent upon review and evaluation of the PBRM Board 
of Governors. 
b. Continuing 
Certification 
of 
the 
Rehabilitation 
Medicine 
Specialist 
A 
Certified 
Diplomate 
of 
the 
Philippine 
Board 
of 
Rehabilitation Medicine, in order to be duly recognized as a 
Rehabilitation Medicine specialist, must undergo recertification 
every three (3) years through PBRM accreditation. 
Section 7. - Technical Standards and Requirements for the 
Registration, Operation and Maintenance of Rehabilitation Medicine 
Facilities in the Philippines. - Technical standards and requirements for 
the registration, operation and maintenance of rehabilitation medicine 
facilities shall apply to all entities performing the activities and functions 
of Rehabilitation Medicine facilities. These shall include the evaluation 
and treatment of all conditions requiring rehabilitation of physical 
disabilities. These standards and requirements shall be formulated to 
protect and promote the health of the people by the operation of 
standard, properly managed and adequately supported Rehabilitation 
Medicine facilities. 
. 
Section 8. Regulatory Authority - Technical standards and 
requirements for the registration, operation and maintenance of 
Rehabilitation Medicine Facilities in the Philippines shall be implemented 
and regulated by the Department of Health - Bureau of Health Facilities 
and Services (DOH-BHFS). 
Section 9. CEassi,fcation of Facilities - Rehabilitation Medicine 
facilities shall be classified according to its institutional character, extent 
of services offered. The bases for the classification of the different 
categories of Rehabilitation facilities are: ( 1) Physiatrist qualification, (2) 
Allied Health personnel staff qualification, (3) Rehabilitation Medicine 
services available and (4) Physical set-up and equipment. 
a. Categories 
7 


1. As to institutional character, Rehabilitation 
Medicine 
facilities are either hospital-based (if operating within a 
hospital set-up) or freestanding (if operating on its own or 
part of a facility other than a hospital). 
2. As to extent, Rehabilitation Medicine facilities maybe 
primary, secondary or tertiary, or home-based. 
3. As to function, a Rehabilitation Medicine facility may be 
utilized for training, service and research or service alone. 
4. As to service, a Rehabilitation Medicine facility can also be 
either general or specialized. 
b. A primary Rehabilitation Medicine facility shall have the 
following: 
1. At least one (1) Philippine Board Rehabilitation Medicine 
(PBRM) eligible physiatrist 
2. 
At least one (1) allied rehabilitation health professional 
3. Rehabilitation Medicine Consultation and Management 
with Physical Therapy services. 
4. 
Physical set-up 
5. 
Medical consultation area 
6. Treatment area to include at least an electro therapy device 
and superficial heating modality and ADL training devices 
Gym area, to include parallel bars, mirror, weights and 
assistive devic+es (canes, crutches and walker) 
7. 
8. Evaluation tools 
9. Adequate utilities (water, electricity and consumables) 
10. First aid kit with basic CPR equipment 
e. A secondary Rehabilitation Medicine facility shall have the 
following: 
1. At least one PBRM Board certified physiatrist 
2. At least one licensed Physical therapist and Occupational 
therapist 
3. Rehabilitation Medicine Consultation and Management, 
Physical Therapy and Occupational Therapy services. 
4. Compliance with the primary category set-up plus deep 
heating modality, manual traction and therapeutic exercise 
equipment for the gym area. 


d. A tertiary Rehabilitation Medicine facility shall have the 
following: 
1. At least one PBRM Board certified physiatrist 
2. At least one licensed Physical therapist and Occupational 
therapist 
3. Rehabilitation Medicine Consultation and Management, 
Physical, Occupational Therapy, Prosthetist/ Orthotist in 
house or referral services, speech therapy in house or 
referral services. 
4. Compliance with the secondary category set-up and 
equipment, 
with 
additional 
two 
superficial 
heating 
modalities, 
medium 
frequency 
modality, 
mechanized 
traction, ultraviolet or cold laser intermittent compression 
unit, mechanized intermittent traction and tilt table with 
additional gym equipment. 
5. A Training/ Service and Research facility, which shall fulfill 
all the requirements as a residency training institution in 
accordance with PBRM guidelines. 
6. A specialized facility which should cater to subspecialty 
conditions in Rehabilitation 
Medicine (Cardiac, Pain, 
Pediatric, Pulmonary, Sports, among others.) shall be 
hospital-based facility with a multi-disciplinary set-up. 
Section 10. Management and Operation of a Rehabilitation Medicine 
Facility. - A Rehabilitation Medicine Facility shall be headed by a 
Rehabilitation Medicine specialist who is either a Philippine Board of 
Rehabilitation Medicine Ckrtified or Eligible Rehabilitation Medicine 
specialist who must assume technical and administrative supervision 
and control of the activities in the said facility. An adequate and effective 
system of documentation, recording and records keeping must be 
maintained for all consultations and services in the facility. The rates for 
consultation and services shall be in accordance with the standards of 
the Philippine Medical Association and PHILHEALTH. 
Section 11. Application for Registration and Issuance of License. - 
Applications for registration and issuance of a license shall be filed by 
the owner or his duly authorized representative with the DOH-Bureau of 
9 


Health Facilities and Services together with an Information sheet to be 
filled up by the physiatrist-in-charge. Upon receipt of the said application 
together with the license fee, a technical committee team will inspect the 
facility within sixty (60) days. Certificates of licenses shall be issued and 
approved by the Head of the Bureau of Health Facilities and Services. A 
provisional license may be granted to facilities with insufficient 
requirements for special cases for a period of one (1) year. 
Section 12. Terns and Validity of License. - The license to operate 
will only be valid for a period of two (2) years. Application for renewal of 
the license shall be made during the last six (6) months of validity. The 
license must be placed in a conspicuous place within the facility. A copy 
of the rules and regulations should also be readily available. Upon 
violation of the standards provided, a license may be revoked. 
Investigation of all charges or complaints against a Rehabilitation 
Medicine facility or any of its personnel shall be made to the PBRM (when 
complaint is against the physiatrist) and to the Department of Health- 
Bureau of Health Facilities and Services for appropriate investigation. 
Section 13. Penalties - Any person, partnership, association, or 
corporation who establishes, operates, conducts, manages or maintains 
a rehabilitation medicine facility within the meaning of this Act without 
first obtaining a license or violates any provision of this Act or its 
Implementing Rules and Regulations shall be liable to a fine of not less 
than Twenty Thousand Pesos (P20,OOO.OO) but not to exceed Fifty 
Thousand Pesos (P50,OOO.OO) for the first offense, and not less than Fifty 
Thousand Pesos (P50,OOO.OO) but not to exceed One Hundred Thousand 
Pesos (P100,OOO.OO) for the second offense, and not less than One 
Hundred Thousand Pesos (P100,000.00), but not to exceed Two Hundred 
Thousand Pesos (P200,OOO.OO) for the third and each subsequent 
offense. Each day that a facility or other related facility shall operate after 
the first violation shall be considered a subsequent offense. 
In addition to the penalties specified in the preceding paragraph, 
the Bureau, upon the approval of the Secretary, may summarily order 
the closure of any rehabilitation medicine facility found operating 
without a license. 
10 


Section 14. 
implement the provj 
mplementing Rules and Regulations (IRR) - To 
ions of this Act, the Department of Health - Bureau 
of Health Facilities and Services ( DOH-BHFS ), in coordination with the 
national professional organization duly recognized by the Professional 
Regulation Commission, 
shall promulgate the rules and regulations, 
including the technical standards and requirements for the registration, 
operation and maintenance of rehabilitation medicine facilities, within 
ninety (90) days after the effectivity of this Act.. 
Section 15. Separability Clause - If any part or provision of the Act 
shall be held unconstitutional or invalid, other provisions hereof which 
, 
are not affected hereby shall continue to be in full force and effect. 
Section 16. Repeating Clause - All laws, decrees, rules and 
regulations inconsistent with the provision of this Act are hereby 
repealed or modified accordingly. 
Section 17. Effectivity - This Act shall take effect fifteen (1 5) days 
after its approval. 
Approved , 
11