Sentate Office of the secretarp TWENTIETH CONGRESS OF THE) REPUBLIC OF THE PHILIPPINES ) First Regular Session OCT 23 A10:48 SEN1460 S.B. No. . RECEIVED BY: Introduced by SENATOR IMEE R. MARCOS AN ACT INSTITUTIONALIZING THE MEDICAL ASSISTANCE TO INDIGENT AND FINANCIALLY INCAPACITATED PATIENTS (MAIFIP) PROGRAM, APPROPRIATING FUNDS THEREFOR, AND FOR OTHER PURPOSES EXPLANATORY NOTE Article II, Section 15 of the 1987 Constitution states that, "The State shall protect and promote the right to health of the people and instill health consciousness among them." In line with the mandate of the Constitution, Republic Act No. 11223 otherwise known as the "Universal Health Care Act" provides that to protect and promote the right to health of all Filipinos, an integrated and comprehensive approach shall be made including the adoption of a health care model that provides all Filipinos access to a comprehensive set of quality and cost-effective, promotive, preventive, curative, rehabilitative and palliative health services without causing financial hardship, and prioritizing the needs of the population who cannot afford such services. However, while there are increasing PhilHealth expenditures and other sources of health financing, a significant proportion of Filipinos continue to have difficulty in accessing health services due to financial constraints. Thus, the proposed measure seeks to institutionalize the Medical Assistance to Indigent and Financially Incapacitated Patients (MAIFIP) Program which aims to provide medical assistance to support clinically-indicated needs prescribed by a physician or health professional for indigent and financially incapacitated in-patients and out-patients in order to ensure quality and adequate delivery of health services particularly in terms of medical assistance. Further, this assistance applies to expenses exceeding the applicable PhilHealth benefit packages, case rates, or other available funding sources. Given the abovementioned circumstances, the approval of this bill is earnestly sought. Imee h. Marca IMEER. MARCOS
Senate Office of the Secretary TWENTIETH CONGRESS OF THE) REPUBLIC OF THE PHILIPPINES ) OCT 23 A10:48 First Regular Session SENATI RECEIVED BY: 1460 S.B. No. - Introduced by SENATOR IMEE R. MARCOS AN ACT INSTITUTIONALIZING THE MEDICAL ASSISTANCE TO INDIGENT AND FINANCIALLY INCAPACITATED PATIENTS (MAIFIP) PROGRAM, APPROPRIATING FUNDS THEREFOR, AND FOR OTHER PURPOSES Be it 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 Assistance
2 to Indigent and Financially Incapacitated Patients (MAIP) Act."
SEC. 2. Declaration of Policy. - It is the declared policy of the State to protect
4 and promote the right to health of the people and instill health consciousness among them. The State shall also improve the adequate delivery of health care services to 6 the people and ensure its availability and accessibility.
SEC. 3. Medical Assistance to Indigent Patients (MAIFIP) Program. - The
Department of Health (DOH) shall establish a "Medical Assistance to Indigent and 9 Financially Incapacitated Patients (MAIFIP) Program" which shall provide medical assistance to support clinically-indicated needs prescribed by a physician or health professional for indigent and financially incapacitated in-patients and out-patients. This assistance applies to expenses exceeding the applicable PhilHealth benefit packages, case rates, or other available funding sources. The MAIFIP Program shall continue to be available and accessible in all DOH central and regional offices, BARMM Ministry of Health, specialty hospitals, DOH hospitals and treatment and rehabilitation centers, including hospitals under the Department of National Defense (DND) and the Department of Interior and Local Government (DILG), State Univerities and Colleges (SUCs) hospitals and Department
1 of Justice (DOJ) infirmaries, local government unit (LGU) hospitals, and other partner 2 government and privately-owned hospitals and health facilities.
SEC. 4. Qualified Beneficiaries. - The qualified beneficiaries of the MAIFIP
4 Program shall refer to indigent and financially incapacitated patients who shall 5 demonstrate clear inability to pay or spend for necessary expenditures for one's 6 medical treatment, such as, but not limited to patients with catastrophic illness or any 7 illness, which is life or limb-threatening and requires prolonged hospitalization, extremely expensive therapies or other special but essential care that would deplete one's financial resources, as assessed and certified by the Medical Social Worker 10 (MSW). Provided that, patients availing of medical assistance or their authorized representatives through the MAIFIP Program in DOH hospitals, other government hospitals and privately-owned hospitals and health facilities shall present documents and undergo proper assessment and evaluation by the MSW or their designated officer. Referrals may also be issued by the DOH Central Office and/or DOH Centers for Health Development (CHDs), subject to the standard screening and evaluation process conducted by the health facility's MSW. The registered MSW of the health facility shall assess the eligibility of patients 19 applying for medical assistance based on their existing assessment standards. Health facilities shall judiciously enforce a thorough screening of beneficiaries to ensure the efficient and rational use of funds, diligent documentation, and data encoding through the information system designated by the DOH.
SEC. 5. Coverage. - The MAIFIP Program shall cover medicines, services, and
other medical products as prescribed by a licensed physician or health professional, such as, but not limited to, the following: (a) Drugs and medicines, as approved by the Food and Drug Administration (FDA); (b) Laboratory, imaging, radiological, and other diagnostic procedures, including assessment/readers' fees; (c) Blood and other related blood screening/products;
(d) Clinically indicated medical-surgical cases, obstetrics-gynecological cases 2 considered as high-risk: cases requiring implants, medical devices, and supplies, and other relevant procedures; (e) Clinically indicated dental cases, including routine preventive oral care, 5 subject to the guidelines issued by the DOH; (f) Dialysis sessions exceeding the coverage and package rates provided by 7 PhilHealth; (g) Prescribed post-hospitalization, rehabilitation services, aftercare program, 9 and appropriate mental and psychosocial support; (h) All hospital bills or charges after all applicable and available deductions; and (i) Professional fees (PF), subject to the guidelines issued by the DOH.
SEC. 6. Program Management. - The DOH shall be responsible for the overall
management and administration of the MAIFIP Program.
SEC. 7. Order of Charging. - The DOH shall establish an order of charging for
available government and private assistance. Hospitals and other partner health facilities shall ensure that double charging of medical assistance funds is strictly prohibited.
SEC. 8. Downloading of Funds. - The DOH shall ensure that the MAIFIP
Program funds appropriated under the annual General Appropriations Act (GAA) shall be available in all DOH hospitals and specialty hospitals at the beginning of every fiscal year and replenish such funds, as necessary, to ensure continuous and uninterrupted assistance to patients through the MAIFIP Program. The DOH, through its CHDs, shall enter into a Memorandum of Agreement (MOA) with LGU hospitals, and other health facilities, both private and public, such as, but not limited to, other hospitals not operated by the DOH, clinical laboratories and primary care facilities, dental clinics, and free-standing dialysis clinics for the availability and transfer of funds of the MAIFIP Program in the health facility.
SEC. 9. Payment Mechanism. - All hospitals and other health facilities under
the MAIFIP Program shall receive and accept letters of guarantee from the DOH as payment for the medical expenses of the beneficiaries. Provided that, the DOH shall remit payment to the health facility to cover the amount of the issued letter of
1 guarantee not later than fifteen (15) days from the availment of medicines and 2 services or upon discharge.
SEC. 10. Monitoring and Reporting. - All health facilities under the MAIFIP
4 Program shall submit their respective monthly Fund Utilization Reports (FURs) to the DOH. The DOH shall submit to the Senate Committee on Health and Demography, 6 and the House of Representatives Committee on Health, on or before the end of 7 December of every year, or upon the request of any of the aforesaid offices, a report 8 giving a detailed account of the status of the implementation of this Act.
SEC. 11. Appropriations. - The amount necessary to implement the provisions
10 of this Act shall be included in the budget of the DOH under the assistance to patients through the MAIFIP Program.
SEC. 12. Implementing Rules and Regulations. — The DOH shall promulgate
the necessary implementing rules and regulations within ninety (90) days from the effectivity of this Act.
SEC. 13. Separability Clause. - If any provision of this Act is held invalid or
unconstitutional, the provisions not otherwise affected shall remain valid and subsisting.
SEC. 14. Repealing Clause. - All laws, executive orders, rules or regulations,
or any part thereof, inconsistent with any provision of this Act are hereby repealed or modified accordingly.
SEC. 15. Effectivity. - This Act shall take effect fifteen (15) days after its
complete publication in the Official Gazette or in a newspaper of general circulation. Approved,