WAIVER OF EXCESS FEES AND CHARGES FOR PHILHEALTH INDIGENT PATIENTS IN ALL DOH RETAINED HOSPITALS

Pursuant to Section 11 of Article XIII of the Constitution of the Republic of the Philippines which states that “(t)he 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 . . .” and to the National Health Insurance Act of 1995 which seeks to provide universal health insurance and ensure affordable, available and accessible health care services for all citizens of the Philippines, the Department of Health (DOH), through its attached agency, the Philippine Health Insurance Corporation (PhilHealth), commits to prioritize the provision of health services to all Filipino especially the indigents who cannot afford such services.

In light of the above, the DOH shall adopt as a policy the waiver of all excess fees and charges for all indigent patients who are enrolled under the National Health Insurance Program and who are admitted to DOH-retained hospitals. To effect this, all DOH-retained hospitals shall be governed by the following:

1. National health insurance/medicare rates shall at all times be the basis for the billing of indigent members;
    
2. There shall be an outright waiver of all excess billings and no charging of any kind of co-payment for all indigent patients confined in medicare wards;
    
3. Hospital pharmacies shall always ensure availability of drugs and medicines which are in the hospital formulary or Philippine National Drug Formulary (PNDF);
    
4. Physicians shall be mandated to prescribe drugs and medicines which are in the PNDF;
    
5. Ordering of diagnostics that are not available within the hospital or medical center shall be minimized;
    
6. A referral system shall be set-up and put in place for necessary but unavailable diagnostics. 

Compliance to/enforcement of the above-mentioned measures shall ensure timely reimbursement by PhilHealth of all claims filed by DOH-retained hospitals for the services rendered to indigent members.

All other government hospitals, particularly Local Government Unit (LGU) hospitals, are hereby encouraged to adopt and/or likewise comply with this directive.

All administrative orders and other orders and issuances inconsistent hereto are hereby rescinded.

This Order shall take effect immediately.

Adopted: 24 July 2002

(SGD.) MANUEL M. DAYRIT, MD, MSC
  Secretary of Health