MANILA, (PNA)—The PhilHealth conducted public consultation on the proposed Implementing Rules and Regulation of the National Health Insurance Act of 2013 (RA 10606) or Universal Health Care.
The consultation held Friday at Crowne Plaza Manila Galleria was attended by representatives from different government and private sectors like doctors from hospitals and specialty clinics, employers, employees, academic institution and other NGOs.
Together with officials of PhilHealth, the event gave the different sectors of society an opportunity to gather and discuss pertinent and other important things about the law.
The consultation is simultaneously done in Baguio, and other areas in Visayas and Mindanao to determine what should be included or excluded under the IRR of the new PhilHealth law.
During the public consultation, Dr. Shirley B. Domingo, vice president of PhilHealth for National Capital region cited the changes and expanded benefits featured under RA 10606.
Dr. Domingo said that the law ensures the coverage of the poor and the marginalized identified by the National Household Targeting System (NHTS) enlisted in the Listahanan of Department of Social Welfare and Development (DSWD).
Among the qualified dependents of every member are its spouse, children below 21 years old, children with congenital conditions regardless of age, parents 60 years old and above, foster child, parents with permanent disability regardless of age.
“It also extended sponsored coverage to orphans, abandoned and abused minors, out of school youths, street children, Persons with Disability (PWDs), senior citizens, battered women under the care of DSWD,” Domingo explained.
Domingo added that those in the informal sector from the lower income segment who do not qualify for full subsidy under the means test rule of the DSWD shall be entirely subsidized by the LGUs or through cost sharing mechanisms between or among LGUs or other sponsors.
“These include barangay health workers, nutrition scholars and others,” she added.
She also said that there will be a health insurance ID card containing a Personal Identification Number (PIN) will be issued to facilitate, identification, eligibility, verification and recording of utilization.
“About P35 billion pesos was allocated by the government in the year 2014 to cover and fully subsidized the poor and near poor to PhilHealth which is equivalent to about 14.7 million families,” said Alexander Padilla, president and chief executive officer of PhilHealth.
Padilla stressed that under the law no balance billing shall be implemented to the poor by the hospital.
“Under the law, the poor should not be subject to paying professional fees for doctors, ask to buy medicine, diagnostic exam and other fees at their own expense because all of these are included in the reimbursement for public hospital,” added Padilla.
Other benefits includes provision of the total cost of patient’s case rate for every sickness or procedures that the patient will undergo.
“Through these the member will know exactly the amount that will be deducted and reimbursed by the PhilHealth to the hospital for every procedure that they had availed from the hospital,” he added.
Failure on the part of the hospital to comply will subject them to necessary investigation to ensure that member’s rights are protected.
“This new law gives PhilHealth the necessary teeth to run after those erring providers who are not thinking of the common good,” he added.