Medical Assistance to Indigent and Financially Incapacitated Patients Act of 2025

TWENTIETH CONGRESS OF THE ) REPUBLIC OF THE PHILIPPINES First Regular Session JUL 10 P4:38 SENATE S. B. No. INTRODUCED BY SENATOR CHRISTOPHER LAWRENCE "BONG" T. GO AN ACT INSTITUTIONALIZING THE MEDICAL ASSISTANCE TO INDIGENT AND FINANCIALLY INCAPACITATED PATIENTS PROGRAM UNDER THE DEPARTMENT OF HEALTH, PROVIDING FUNDS THEREFOR, AND FOR OTHER PURPOSES EXPLANATORY NOTE Republic Act No. 11223 or the Universal Health Care (UHC) Act, aims to ensure that all Filipinos have equitable access to quality and affordable health care while providing financial protection. In line with this, Republic Act No. 11463 or the Malasakit Centers Act was passed to adopt a multi-sectoral and streamlined approach in providing medical and financial assistance to indigent and financially incapacitated patients. The benefits under the UHC rely on health benefit packages under the National Health Insurance Program managed by Philhealth. As such, out-of-pocket expenditures may still arise if the benefit packages are not enough to cover the medical needs of patients. To address this, the Department of Health continues to implement a medical assistance program that would cover out-of-pocket expenditures of qualified patients. While this program is available in DOH hospitals and other public health facilities with established Malasakit Centers, there is a need to institutionalize the program to ensure its continuing availability to other health facilities, both public and private.

This proposed measure seeks to institutionalize the Medical Assistance to Indigent and Financially Incapacitated Patients to reduce, if not eliminate, out-of- pocket expenditures of indigent and poor patients. This way the State can make medical assistance more accessible to all Filipino patients needing assistance. In view of the foregoing, approval of this bill is earnestly sought. SENATOR CHRISTOPHER LAWRENCE "BONG" T. GO

TWENTIETH CONGRESS OF THE ) REPUBLIC OF THE PHILIPPINES First Regular Session 25 JUL 10 P4:38 SENATE S. B. No. _ INTRODUCED BY SENATOR CHRISTOPHER LAWRENCE "BONG" T. GO AN ACT INSTITUTIONALIZING THE MEDICAL ASSISTANCE TO INDIGENT AND FINANCIALLY INCAPACITATED PATIENTS PROGRAM UNDER THE DEPARTMENT OF HEALTH, PROVIDING FUNDS THEREFOR, AND FOR OTHER PURPOSES Be it enacted by the Senate and House of Representatives of the Philippines in Congress assembled:

SECTION 1. Short Tit/e. - This Act shall be known as the "Medical Assistance

2 to Indigent and Financially Incapacitated Patients Act of 2025."

SEC. 2. Declaration of Policy. - It is the declared policy of the State to improve

§ the delivery of health care services to the people, and to ensure financial assistance 6 for hospital and medical expenses are available and accessible to the people.

SEC. 3. Medical Assistance Program. - The Department of Health shall

establish a Medical Assistance to Indigent and Financially Incapacitated Patients (MAIFIP) Program that 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 Malasakit 16 Centers as provided under Republic Act No. 11463 otherwise known as the "Malasakit

1 Centers Act". Malasakit Centers shall continue to facilitate the provision of medical assistance under the MAIFIP program in all DOH hospitals and other public hospitals with established Malasakit Centers. The MAIFIP program shall also be made available in 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.

SEC. 4. Qualified beneficiaries. - The following shall be qualified as

10 beneficiaries of the MAIFIP Program: (a) Indigent patient — refers to a Filipino patient who has no visible means of income or whose income is insufficient for the subsistence of their family as assessed by the medical social worker of the health facility; and (b) Financially incapacitated patient - refers to a Filipino patient who is not classified as indigent but who demonstrates a clear inability to pay or spend for necessary expenditures for their respective medical treatment such as, but not limited to, a patient with catastrophic illness or illnesses which are life or limb-threatening and require prolonged hospitalization, illnesses that require extremely expensive treatments, or other special but essential care that would deplete one's financial resources, as assessed and certified by the Medical Social Worker (MSW) of the health facility. Patients availing of medical assistance or their authorized representative/s through the MAIFIP Program in DOH hospitals, other government hospitals and private hospitals 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 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. Service Coverage. - The MAIFIP Program funds 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 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, subject to the guidelines issued by the DOH; (f) Dialysis sessions exceeding the coverage and package rates provided by PhilHealth; (g) Prescribed post-hospitalization, rehabilitation services, aftercare program, and appropriate mental and psychosocial support; (h) All hospital bills/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 Malasakit Program Office (MPO) created

under R.A. 11463 shall be responsible for the overall management and administration of the MAIFIP Program. The MPO shall establish linkages and networks with health facilities through the Malasakit Program Unit (MPU) in CHDs and Ministry of Health (MOH)-BARMM to provide efficient coordination necessary for MAIFIP Program implementation.

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 avoided.

SEC. 8. Downloading of funds. - The DOH shall ensure that the MAIFIP

3 Program funds appropriated under the annual General Appropriations Act shall be available in all DOH hospitals and specialty hospitals at the beginning of every fiscal 5 year and replenish such funds as necessary to ensure continuous and uninterrupted assistance to patients through the MAIFIP program. Funds shall also be made available 7 in all public hospitals with established Malasakit Centers. The DOH, through its CHDs, shall enter into a Memorandum of Agreement 9 (MOA) with LGU hospitals, and other health facilities, both private and public, such as, 10 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 of the MAIFIP program in the health facility. The DOH, through its CHDs, shall transfer funds to LGU hospitals, and other aforementioned health facilities, both private and public, through a MOA between the health facility and the DOH.

SEC. 9. Payment mechanism. - All 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 guarantee not later than fifteen (15) days from the receipt of such letter of guarantee.

SEC. 10. Monitoring and reporting, - All health facilities under the MAIFIP

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, and the House of Representatives Committee on Health on or before the end of December of every year, or upon the request of any of the aforesaid offices, a report giving a detailed account of the status of the implementation of this Act.

SEC 11. Appropriations. - The amount necessary to implement the provisions

of this Act shall be included in the budget of the Department of Health under the

annual General Appropriations Act.

SEC. 12. Separability Clause. - Any portion or provision of this Act that is

4 declared unconstitutional shall not have the effect of nullifying other portions or provisions hereof as long as such remaining portions can still subsist and be given effect in their entirety.

SEC. 13. Repealing Clause. - All laws, ordinances, rules, regulations, other

issuances or parts thereof, which are inconsistent with this Act, are hereby repealed 10 or modified accordingly.

SEC. 14. Effectivity. - This Act shall take effect fifteen (15) days after its

publication in the Official Gazette or in a newspaper of general circulation. Approved,