Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

EIGHTEENTH CONGRESS
1 Regular Session
4230

House Bill No.

Introduced by Representatives ERIC GO YAP, JOCELYN PUA TULFO, and
ROWENA NINA TADURAN

EXPLANATORY NOTE

Healthcare in the Philippines is fluid, ranging in quality from excellent to poor
depending on one's social class. Hospitals in the urban area, especially in major cities,
are generally of a first-class service, while many in rural areas lack infrastructure and
medical facilities. More so, while there are available medical facilities in the urban
area, its affordability becomes an issue for most of those who need it.

The provision of basic health services and rendering of financial assistance to
those who are in distress remains limited. Furthermore, seeking help from different
agencies prevails to be a challenge to the people who seek financial assistance to cover
their medical expenses.

In understanding this unfortunate event and in line with the President's
directive to help the underprivileged, the Malasakit Center was conceptualized, The
Malasakit Center is a presidential mandate instituted by the Office of the Presidential
Assistant to the President (OSAP) in cooperation with different agencies such as;
Department of Health (DOH), Philippine Charity Sweepstake Office (PCSO),
Department of Social Welfare and Development (DSWD), and Philippine Health
Insurance Corporation (Philhealth). It is a one-stop service center of various
government agencies bringing their services closer to the poor and marginalized
people as these centers will be located in hospitals run by the government. Its
establishment will minimize the complicated medical assistance procedures and will
expedite the medical services required as agencies will be housed in one location,
lessening the burden of our fellowmen.

The presence of Malasakit Center plays an important role in delivering basic
health services to our people. It houses desk representatives from DOH, DSWD, PCSO
and Philhealth so the people are able to process their requirements without having to
leave the medical institution.


This bill seeks to reduce and if possible, to cover all the expenditures of the
indigent and poor patients. In this way, we can fully deliver the basic health services
to our communities in a humane manner.

Asa manifestation of support to this administration’s effort to serve the people
in this country, thus, the approval of this bill is earnestly sought

ERIC GO YAP

ROWEN: INA\TAD) N


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

EIGHTEENTH CONGRESS
1 Regular Session

4230
House Bill No. __

Introduced by Representatives ERIC GO YAP, JOCELYN PUA TULFO, and
ROWENA NINA TADURAN

AN ACT

INSTITUTIONALIZING MALASAKIT CENTERS TO COMPLEMENT
THE IMPLEMENTATION OF REPUBLIC ACT NO. 11223 OTHERWISE
KNOWN AS THE 'UNIVERSAL HEALTH CARE ACT' BY REQUIRING
PHILHEALTH TO _ ESTABLISH, OPERATE AND MAINTAIN
MALASAKIT CENTERS IN ALL DOH, LGU, SUC AND DND HOSPITALS
IN THE COUNTRY, 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 Policy. - It is declared policy of the State to
improve the delivery of health care service to people, and to ensure financial
assistance for hospital and medical expenses are available and accessible to the
people.

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

(a) 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;

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


(c) 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;

(a) Indigent Patient refers to a 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), LGU social worker or the medical social worker of the health
facility;

(e) Local Government Unity (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;

(g) Medical Assistance refers to assistance for out-of-pocket expenditure in
form of coupon, stub, guarantee letter, promissory note, or voucher
that has monetary value, given to individual recipients or
beneficiaries to address their immediate needs;

(h) 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;

(i) Poor Patient refer 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 RA 9262 or the Anti-
Violence Against Women and Their Children Act of 2004 and
RA 7610 or the Special Protection of Children Against Abuse,
Exploitation, and Discrimination Act;

2. Patients with catastrophic illness or any illness as a primary
condition that is life or limb0threathening 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 defines by RA 9745
or the Anti-Torture Act of 2009;

5. Soldiers and police 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; and

(j) 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 shall be established a Malasakit Center in each DOH, LGU, DND, and
SUC hospital in the country which shall serve as (a) processing center for all
Philhealth concerns 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.

The Philhealth shall administer and manage the Malasakit Centers in
close coordination with the DOH and DSWD. Each Malasakit Center shall
consist of duly designated representatives from the Philhealth, DOH, and
DSWD with the following delegation of functions:

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 RA 11223, including but not limited
to coverage, billing, health benefits packages, financial concerns. The
Philhealth representative shall also assist in patient navigation and
referral to the health care provider network;

2. The DOH representative 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 and poor patients.

SECTION 5. Provision of Medical Assistance. - The DOH shall provide
medical assistance to indigent and poor patients though 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 and grants 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 procedure,
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 RA 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 (exemptions to be cleared by Pharmaceutical Division);

c. Supplies, orthopedic/assistive devices, prosthesis, blood and blood
products;

d. Dental services, except those that are for aesthetic purpose and not
medically indicated;

e. 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;

g. In case of non-availability of clinically indicated drugs, medicine,
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;

h. 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. Allother 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 attending physician, approved by
the Chief of Hospital/Medical Center Chief 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
economical 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 difficult circumstances. The DSWD shall issue policies and
guidelines on the release of such assistance for the proper implementation of
the program.

SECTION 8. Establishment of Malasakit Centers. - The Philhealth and
DOH 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 level 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 may enter into a Memorandum of Agreement with
private hospitals for the establishment of Malasakit Centers which shall cater
indigent and poor patients of the private hospital.

SECTION 9. Donations from Non-Governmental Organizations and
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. As such, the donor may send his
or her representatives to the Malasakit Center for the provision of the medical
assistance donated by the donor in the particular hospital.

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
electric 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. Appropriation. - 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, 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. - If any part or provision of this Act
shall be held unconstitutional or invalid, other provisions hereof which are not
affected thereby shall continue to be in full force and effect.

SECTION 13. Repealing Clause. -All laws, decrees, executive orders
and proclamations, rules and regulations or parts thereof that 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 in at least two (2) national
newspaper of general circulation, whichever comes earlier.

Approved,