NINETEENTH CONGRESS OF THE )
REPUBLIC OF THE PHILIPPINES )
First Regular Session )

HOUSE OF REPRESENTATIVES. ..

3189 Nt

H. B. No.

Introduced by Representative Ralph G. Recto

AN ACT
DESIGNATING THE SECRETARY OF HEALTH AS THE EX-OFFICIO
CHAIRPERSON AND VOTING MEMBER OF THE PHILIPPINE HEALTH
INSURANCE CORPORATION (PHILHEALTH) BOARD OF DIRECTORS,
AMENDING FOR THE PURPOSE REPUBLIC ACT NUMBER 11223,
OTHERWISE KNOWN AS THE UNIVERSAL HEALTH CARE (UHC) ACT

EXPLANATORY NOTE

Ensuring that alt Filipinos are guaranteed equitable access to quality and
affordable health care goods and services, and protected against financial risk is one
of the primordial objectives of Republic Act No. 11223, otherwise known as the
Universal Health Care (UHC) Act. When the UHC Act was enacted in 2019, the
landmark law carried with it high hopes of implementing comprehensive and
progressive reforms to ensure that all Filipinos will have access to affordable, quality,
and readily available health service that is responsive to their needs.

One of these reforms is the clear definition of the roles of the Philippine Health
Insurance Corporation (PhilHealth) in the attainment of universal health care goals.
PhilHeaith’s primary mandate is to ensure that all Filipinos are granted automatic
membership, therefore, making them eligible to claim benefits provided under the
National Health Insurance Program. The Corporation is responsible for financing
universal health care as well as ensuring that the National Health Insurance Fund is
managed properly and will be actuarially viable. To this end, the UHC Act mandated
the composition of its Board of Directors, a balance between government officials and

expert and sectoral members to represent all key stakeholders. It also provided for


the minimum qualification standards for the members of the Board as well as its top

management officials.

The coronavirus pandemic, however, showed some loopholes in the UHC Act
as far as PhilHealth’s Board of Directors is concerned. Several policy issues during the
onset of the pandemic drew flak for PhilHealth. Incoherent policies between PhilHealth
and the Department of Health (DOH) specifically governing COVID-19 testing early in
the pandemic were red-flagged. The Interim Reimbursement Mechanism (IRM) which
was supposed to expedite the payment of PhilHealth by frontloading funds to
accredited health facilities also became a policy controversy. Private hospitals also
reported huge outstanding balances or account receivables from PhilHealth and
payment or claims processing was said to have taken too long during the pandemic.

While these problems were surfacing one by one, Congress’ initial intervention
was to call on the Secretary of Health (SOH) to explain during the congressional
hearings on COVID-19. It was apparent, however, during those hearings that the SOH
was not fully knowledgeable nor responsible for many of the policies issued by the
PhilHealth Board. It was later pointed out that the SOH is an ex-officio nonvoting
Chairperson of the PhilHealth Board of Directors, making it difficult to pinpoint
accountability in a period of a public health emergency.

Harmonizing the policies of DOH and PhilHealth is imperative to realize the
goals and maximize the gains of the UHC Act. The DOH and PhilHealth as the main
implementors of the law must always be in sync as far as policies are concerned. Only
then can the UHC Act be implemented efficiently and effectively.

This bill aims to designate the SOH as the ex-officio voting Chairperson of the
PhilHealth Board of Directors and require the said official to be present in all meetings
that need Board actions. By doing so, coherence and harmonization of policies can be

ensured. More importantly, accountability is clearer and guaranteed,

In view of the foregoing, immediate passage of this bill is earnestly sought.

PH ce)


NINETEENTH CONGRESS OF THE )
REPUBLIC OF THE PHILIPPINES )
First Regular Session )

HOUSE OF REPRESENTATIVES
H. B. No. 31 89

Introduced by Representative Ralph G. Recto

AN ACT
DESIGNATING THE SECRETARY OF HEALTH AS THE EX-OFFICIO
CHAIRPERSON AND VOTING MEMBER OF THE PHILIPPINE HEALTH
INSURANCE CORPORATION (PHILHEALTH) BOARD OF DIRECTORS,
AMENDING FOR THE PURPOSE REPUBLIC ACT NUMBER 11223,
OTHERWISE KNOWN AS THE UNIVERSAL HEALTH CARE (UHC) ACT

Be it enacted by the Senate and House of Representatives of the Philippines in
Congress assembled:

SECTION 1. Section 13 of Republic Act No. 11223 is hereby amended to read as

follows:

Section 13. PhilHealth Board of Directors. —

(a) The PhilHealth Board of Directors, hereinafter referred to as the Board,
is hereby reconstituted to have a maximum of thirteen (13) members,
consisting of the following: (1) five (5) ex-officio members, namely: the
Secretary of Health, Secretary of Social Welfare and Development, Secretary
of Budget and Management, Secretary of Finance, Secretary of Labor and

Employment; (2) three (3) expert panel members with expertise in public
health, management, finance, and health economics; and (3) five (5)
sectoral panel members representing the direct contributors, indirect
contributors, employers group, health care providers to be endorsed by their
national associations of health care institutions and health care professionals,
and representative of the elected local chief executives to be endorsed by
the League of Provinces of the Philippines, League of Cities of the Philippines
and League of Municipalities of the Philippines: Provided, That at least one


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(1) of the expert panel members and at least two (2) of the sectoral panel
members are women.

The sectoral and expert panel members must be Filipino citizens and of good
moral character.

The expert panel members must: (i) be of recognized probity and
independence and must have distinguished themselves professionally in
public, civic or academic service; (ii) be in the active practice of their
professions for at least seven (7) years; and (iii) not be appointed within one
(1) year after losing in the immediately preceding elections, whether general
or special.

(b)The Secretary of Health shall be an ex-officio [nonvoting] VOTING
Chairperson of the Board. THE SECRETARY OF HEALTH OR HIS/HER
REPRESENTATIVE MUST BE PRESENT AND ACT AS THE
CHAIRPERSON IN ALL MEETINGS THAT REQUIRE BOARD ACTIONS
OR RESOLUTIONS.

(©) All appointive members in the Board shall be required to undergo training
in health care financing, health systems, costing health services and HTA
prior to the start of their term. Noncompliance shall be a ground for
dismissal.

Within thirty (30) days following the effectivity of this act, the Governance

Commission for Government-Owned or — Controlled Corporations (GCG) shall,

in accordance with the provisions of Republic Act No. 10149, promulgate the

nomination and selection process for appointive members of the Board with a

clear set of qualifications, credentials, and recommendation from the concerned

sectors.

Sec. 2. Separability Clause, — If any part or provision of this Act shall be held
unconstitutional or invalid, other provisions, which are not affected thereby, shall
continue to be in full force and effect.

Sec. 3. Repealing Clause. — All laws, decrees, orders, rules, and regulations or
‘other issuances or parts thereof which are contrary to and inconsistent with the
provisions of this Act are hereby repealed or modified accordingly.

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1 Sec. 4. Effectivity. - This Act shall take effect fifteen (15) days after its
2. publication in the Official Gazette or in at least two (2) national newspapers of general
3 circulation.

Approved,