Accessible Kidney Care Act

Senate Office of the sentretary TWENTIETH CONGRESS OF THE 26 MAY -7 P2:04 REPUBLIC OF THE PHILIPPINES First Regular Session RECEIVED BY: SENATE S. No. 2123 Introduced by Senator Raffy T. Tulfo AN ACT MANDATING THE ESTABLISHMENT OF DIALYSIS CENTERS, EXPANDING ACCESS TO KIDNEY DISEASE DETECTION AND DIALYSIS TREATMENT SERVICES, AND APPROPRIATING FUNDS THEREFOR EXPLANATORY NOTE An estimated 13 million Filipinos are diagnosed with various stages of chronic kidney disease (CKD). Making up for 11.2% of the Philippine population. 1 According to the Philippine Society of Nephrology, with one Filipino developing chronic renal failure per hour, about 120 Filipinos per million population suffer from the disease annually? The Philippine Renal Disease Registry also reported that 57.44% of kidney disease patients are between 20 and 59 years old, surpassing senior citizens with kidney disease, who account for 40.82% of cases. Unfortunately, younger age groups are likewise affected, with patients aged 10 years old below accounting for 1.11% and aged 11-19 accounting for 0.62% of CKD cases.3 1 Dy-Zulueta, D. (2026, April 27). Barangay-based kidney health screening launched. Philstar.com. https://www.philstar.com/lifestyle/health-and-family/2026/04/27/2523934/barangay-based-kidney- health-screening-launched Philippine Society of Nephrology. (2024, March 1). Rising incidence of chronic kidney disease in the Philippines sparks call for kidney health awareness: The Philippine Society of Nephrology urges Filipinos to take proactive measures. https://psn.org.ph/2024/03/01/rising-incidence-of-chronic-kidney-disease-in-the-philippines-sparks-call- for-kidney-health-awareness-subtitle-the-philippine-society-of-nephrology-urges-filipinos-to-take- proactive-measures/ 3 More young Pinoys getting chronic kidney disease and they learn too late. Inquirer.net. (2026) https://newsinfo.inquirer.net/2157336/more-young-pinoys-getting-chronic-kidney-disease-and-they- learn-too-late

With over 50% of CKD cases detected only at stages 3 to 5, late diagnosis is unfortunately common. Risk factors that influence the likelihood of developing CKD include high blood pressure, diabetes, family history of kidney disorders, heart disease, smoking, being overweight and over 60 years of age. Early detection is key to avoiding the emotional, physical and financial strain that late-stage CKD imposes on patients. At present, even essential diagnostic procedures such as the Urine Albumin-to-Creatinine Ratio (ACR) test, which is crucial for the early detection and monitoring of kidney disease, remain inaccessible to many patients as these are not covered by PhilHealth and may cost around PHP 1,500 to PHP3,500 per test. On the otherhand, annual costs for CKD management increase with disease advancement, ranging from PHP 44,610 to PHP 116,590 for non-diabetic patients and PHP 46,451 to PHP 120,948 for diabetic patients. According to the PhilHealth Dialysis Database, CKD Stage 5 patients enrolled in the insurance are entitled to a maximum of 156 hemodialysis sessions per year. PhilHealth covers as much as PHP 990,600 in annual dialysis treatment costs per patient. In perspective, 156 hemodialysis sessions will fully cover a patient undergoing three sessions per week. This means that patients requiring more than three sessions per week will have to pay for the corresponding fees not covered by PhilHealth. For most Filipinos even one session of dialysis cripples their finances for a whole month, let alone paying for multiple sessions not covered by PhilHealth for just one week. This bill seeks to combat the growing public health crisis of chronic kidney disease by mandating free kidney health screening and dialysis services for indigent Filipinos. Recognizing that late diagnosis and prohibitive treatment costs remain the foremost barriers to kidney health. By reducing the cost of treatment and screening, this bill aims 4 Villanueva, A. R., et al. (2025). Cost-of-illness analysis of chronic kidney disease (CKD) management in the Philippines. Journal of Medical Economics, 28(1). https://doi.org/10.1080/13696998.2025.2481766 5 https://www.philhealth.gov.ph/news/up/article/2025/news 67e9e793775ed.php

to help prevent complications, reduce CKD-related mortality, and alleviate the long-term burden on both Filipino families and the public health system. In view of the foregoing, immediate approval of this measure is earnestly sought. RAFFY T. TULFO M

Senate Difice of the Secretary TWENTIETH CONGRESS OF THE MAY -7 P2:04 REPUBLIC OF THE PHILIPPINES First Regular Session ) RECEIVED BY: SENATE S. No. 2123 Introduced by Senator Raffy T. Tulfo AN ACT MANDATING THE ESTABLISHMENT OF DIALYSIS CENTERS, EXPANDING ACCESS TO KIDNEY DISEASE DETECTION AND DIALYSIS TREATMENT SERVICES, AND APPROPRIATING FUNDS THEREFOR 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 "Accessible Kidney Care Act".

Sec. 2. Declaration of Policy. - It is hereby declared the policy of the State to ensure

accessible, affordable and quality health care services to all the people. To this end, the State shall establish dialysis facilities in all national, regional, and provincial hospitals and guarantee free dialysis treatment and kidney health screening services to indigent patients.

Sec. 3. Definition of Terms. - For the purposes of this Act:

(a) National Government Hospita/ refers to any hospital operated and maintained, either partially or wholly, by the National Government or by any department or division, board, or other agency thereof; (b) Regional Government Hospital refers to a hospital operated and maintained either partially or wholly by the Regional Government or by any department, division, board, or other agency thereof; (c) Provincial Government Hospital refers to a hospital operated and maintained either partially or wholly by the Provincial Government or by any department, division, board, or other agency thereof; and

(d) Indigent Patient refers to a patient who has no visible means of income or whose income is insufficient for family subsistence, as certified by the Department of Social Welfare and Development (DSWD).

Sec. 4. Establishment, Operation and Maintenance of a Dialysis Ward or Unit. - Within

two (2) years from the effectivity of this Act, all national, regional, and provincial 6 government hospitals shall establish, operate, and maintain a dialysis ward or unit 7 equipped with necessary machine, equipment, and supplies to provide adequate 8 treatment for patients with renal disease.

Sec. 5. Free Dialysis Treatment for Indigent Patients. - All indigent patients shall be

entitled to free dialysis sessions in any national, regional, and provincial government hospital. The Department of Health (DOH) shall prescribe the guidelines to ensure equitable access and prevent abuse of this benefit.

Sec. 6. Free Kidney Health Screening for Indigent Patients. - All dialysis facilities

14 established pursuant to this Act shall provide free kidney health screening and diagnostic services for indigent patients for purposes of early diagnosis, monitoring, and prevention of kidney disease.

Sec. 7. Penalty. - Any hospital chief, administrator or officer-in-charge who fails to

comply with this Act shall be punished with a fine of Fifty Thousand Pesos (PHP 50,000.00) but not more than One Hundred Thousand Pesos (PHP 100,000.00).

Sec. 8. Appropriations. - The amount necessary for the implementation of this Act

shall be charged from the appropriations of the DOH under the current General 22 Appropriations Act. Thereafter, such sum as may be necessary for the continued 23 operation of the center shall be included in the annual general appropriations act.

Sec. 9. Implementing Rules and Regulation. - Within sixty (60) days from the

effectivity of this Act, the DOH, in coordination with concerned agencies and stakeholders, shall promulgate the necessary rules and regulations: Provided, That the failure of the promulgation of the said rules and regulations shall not prevent the implementation of this Act upon its effectivity.

Sec. 10. Separability Clause. - Should any provision or part of this Act be declared

2 unconstitutional or invalid, the other provisions and parts hereof, insofar as they are 3 separable from the invalid ones, shall remain in full force and effect.

Sec. 11. Repealing Clause. - All laws, decrees, orders, issuances, rules and regulations

5 or parts thereof which are inconsistent with this Act are hereby repealed or modified 6 accordingly.

Sec. 12. Effectivity. - This Act shall take effect fifteen (15) days after its publication in

8 the Official Gazette or in at least two (2) newspapers of general circulation. Approved,