AMENDMENT TO THE TRANSITORY PROVISION OF PHILHEALTH CIRCULAR NO. 40, S. 2000, RE “IMPLEMENTING GUIDELINES FOR OUTPATIENT CONSULTATION AND DIAGNOSTIC PACKAGE UNDER THE MEDICARE P…

This policy amendment aims to provide our members increased
accessibility and improved efficiency in the delivery of health care
services. This also promotes primary health care and supports the
holistic approach towards attaining and sustaining universal coverage of
membership under the Sponsored Program and benefits delivery.

Chapter III, 3.2 Transitory Provisions

“In the event that the Rural Health Unit or Health Center where
the indigent members are initially assigned is not accredited to provide
the out- patient consultation and diagnostic package based on the set
standards for accreditation, the following provisions shall be observed
until such time the RHU qualifies for accreditation;

Implementing Unit – PhilHealth accredited
city/municipal/district/provincial hospitals shall be the main
implementing units and first line of providers. They shall be
authorized by PhilHealth to provide the services under the program on a
quarterly basis;”

shall be amended as follows:

“The Corporation shall honor all existing and all other
accredited hospitals which are recommended for authorization to provide
the out patient consultation and diagnostic (OPB) package for enrolled
Sponsored Program members without prejudice to accredited rural health
unit/center in the locality. These authorized hospitals, however, shall
provide the OPB package for maximum of two (2) years only from the effectivity of this circular. Thereafter, the provider for the OPB
package shall only be an accredited rural health unit/ center in the
respective city/municipality.”

This order shall take effect immediately.

Adopted: 11 Apr. 2009

(SGD.) DR. REY B. AQUINO
President and CEO