SEES Rep of eBay Congress af the Pjilippines Si se Storie Congres ‘ied Regular Sesion Begun and hol in Metro Mania, on Mendy, the swans “dao iy, two thousand ephtean, [Rerusuic Act No. 11223] AN ACT INSTITUTING UNIVERSAL HEALTH CARE FOR ‘ALL, FILIPINOS, PRESCHIBING REFORMS IN THE HEALTH CARE SYSTEM, AND APPROPRIATING FONDS THEREFOR Be itenacte ty the Sonateaa Hous of Representa ofthe ‘Philippinen Congres oss bled cuapran 1 GeineaL, Paovisions ‘he “Univereal Health Care Act” SBC. 2 Declaration of Prince and Policies — 1 ix the pony of the State to protect nd promt the Hight heath ofall pos and snc health conatsnunens ey them. Towards ths end, the State shal ape (© Am interatd and comprehensive apprach tense il Flpinae are heath Mera, proviled wih heathyliving conditions, and protected fom hazande an ‘oul tect thu health that (8) A bald care model that provide ll Fine aoe to.acomprehonste et of quay and cot-tetve poste, [revetre,eatie, mbaitatve and plate lin servis Wichout causing nani hardship, and prints the nods ‘of the population sho cannot aff nich services © A framework thet fosters x whole-of-eystem, whohogoverament and whole-ofsocisyppecach fn the evelopment, implementation, mentoring, aid ealuation of health police, programs and plans: and (@ A peopleorinted approach forthe delivery health ness that oontered on peoples needs nod welbeing. aod ‘Sipniant of the dferense in culture, value ad bells, ‘SEC. 5. General Objective. ~ Thin Ac seks wo (2) Progresively realize univere] health care in the ‘county thaigh a ojetomie approach and lear deiestion of Feles of key agencies and takeholdere towards beter performance inthe health ayaa ad (©) Ensure that all Plipinos are guaranteed oysitabie cus to quai and afedable health care goods and serves, Sod protsed apninat nasal isk 880. 4 Definition of Terma ~ Az aod in this At (@) Abuse of authority zefere to an oct of 9 person perfeming a duty or function that goes beyond what x othard by thie Act and Republic Act No 787, otherine Known at the "National Health Insuranoy Act of 1998s smoned, or thoi implementing vlea abd vegalations ORE, fd i inne tthe pol (8) Ament sefo oft ofthe belt sevice thst provide comfort or convenience, such ay. private Sccommedation ir ondioning,tlphon, tatiana Sic of moa, emong other (©, Bose or word excommodation refers to the provision of ropular meal bed in shaved tom, fos ventilation, and ‘hare tet sot bath @) Coineurance refers ta percentage of medical barge that ls pl by the inewed, with the rest pid by the boa inmueane plans (© Copayment fers oa Mt fo o predetermined rte pri t point of servis Direct contributors refer to those who have the ‘xpacty fo pay premiums, re gainflly employed and are tn ya herrea ‘uulifed dependents, and Ictime members (© Bherzoncy refers to @ cnton or stat of a patint ‘wborein bared onthe objective Sndinge of a pradent acca ‘tice on duty, there is tnmedate danger and where delay {Bint support and trentment cay couse kon of Me or DPermancot diobity wo the patient or in the case of « Pregnant women, permeneat jury ay lee of her unbors GML, or # nonanabitutenal delivers (3) Ratloment refers to any singular or package of ‘health sorvcee provided to ilps for tho purpose af improving hea © Bssntiat heath benefit pacage refers 10 9 st of individual bed enitlements covered by the Notional Health Insurance Program (NHIP) which sndudes primary care dine, agnostics and Iboatry: ad preventive, crave, fn rehaileative servos © Proudulnt ot refers to any act of misreprsentation or deception rosling in undue Benet av advantage om the part of the doer of any meane that deviete fom novel Procedure and is undertaken for persinal gain, resulting fhevefter to damage ad pres which may be capable of (Health care provider rere to any ofthe flowing() A health facility, which nny be public or private, Aovoted primanly 10 the’ provialon of servions for health Promotion, prevention, diagnosis, tetten,rehabiaton snd Pallacon of individuals sulin fom lines deat. tjuy, ‘ably, deformity, or in need of theta oy ether ‘medial and nursing ce 2A elth care profesional, who may be doctor of smotizing, nurs, midi, dentist, et other lied profesional or practioner duly Heensod to practe io the Philippines: (A community-based health core organization. which is an axsoraton of members ofthe comsnunty organized fo the purpone of improving the helth mas ofthat sammy (@ Pharmacies or drug outlets, laborateries and Aiagnetic chimes Healthcare provider network refers to group of brimary to teria care provider, whether pablo private, Gllering pooplecentered and comprehensive care in a Integrated and coordinated manner wilh the primary care ‘proider acting seth naenor ad erin f hos cre ‘within the twee (2) Health Mintnance Organization (HMO) rere to 99 tity that proves, lio overs designate lth servos {ris plan hodere or ones fora fixed prepaid premien (@)_Heolth Technology Asetament(HTA) rene ta the “devices, medicines, varenes, prosesee and al oer haithreated ayes deveaped to Solve a hea problem and amprove quale ves end oath ‘utsomes,utlsing a muldscpinary prosne wo evalute the ‘conomle, organisational, and ethical issuer of ‘hal servation arate (ch nar coneiutors refer to sl thee noting edict contributor, a well a their quaied dependents ‘hae premium shall fe subd By te alia goverment Inking thowe who a ebwidnd e e rol of pec lowe (@)_Individuot-tsed Neath services safer to services ‘which can be sessed within 9 helt feito fentely tat an bo defintely traced back to one (1) vases ited fle at a popelatn love and dice not alter the eaderyng fause of ness auch au ambulatory and inpatient care ‘medicines, Inborstry tented proceduss, among oer, (@ Population toad health sovins refer to inerenns such ‘St heath promotion, insae eurvellne, ed vector ‘onto, which have population groupe as repent (© Primary cave velo to intial-contac, sooeible, continuous, comprehensive and coordinated care tht is faeces gt the tine of need induding a mange of sees for all presenting conditions, ond the ability t coordinate efor to other bealth care providers in the health cre Aelvery stom, When neceesr Primary care provider refs to 9 health esre worker, with defined competencies, who has received Cerietion in primary crews dotormanad by the Department bf Heath (DOH) or any health natuon thee Lael and Cersed by the DOH: (0) Private heath inewrance seers to coverage of 9 Aofined set of health services financed. through Private payments in the form oft prsaum te the inure and (9) Unethical act eerste any action, scheme or ply sgpioat the NHIP, sich te ovetiling upeasing, harboring For patients or reritvent practi ny ac contrary 16 the Code of Ethics ofthe mespanable povsn'eproieson oF pratite, or other simay,enalogous act Dat pat of end Dut in direpate the intgrty ant effective implementataon of the NIP. ‘CHAPTER IL ‘UnovinsaL HEALAH Cane (L1G) S$. 5. Population Coverage. ~ very Pilipino stizen hall be automaticaly insted Into the NHIP, herinater fefered a0 tho Progra