Guidelines on Medical Assistance to Indigent and Poor Patients in Government Hospitals

July 15, 2014

DOH ADMINISTRATIVE ORDER NO. 2014-0024

 

I. Background and Rationale

Republic Act No. 10633, the General Appropriations Act (GAA) of FY 2014, allocated Php3.193 Billion fund to complement the existing Medical Health Care Assistance Program of the Department of Health (DOH). The fund shall be utilized for the grant of assistance to indigent or poor patients.

II. Scope

These guidelines shall apply to all offices and persons involved in the implementation of medical assistance to indigent and poor patients in government hospitals.

III. Objective

These guidelines are promulgated to rationalize the process in the allocation and utilization of the medical assistance fund.

IV. Definition of Terms

1. Government Hospitals — refers to hospitals owned or managed by the government through the DOH, Local Government Units (LGUs) and State Universities and Colleges (SUCs).

2. Medical Assistance Fund — represents the allocation in the 2014 GAA intended for medical assistance to indigent or poor patients.

3. Retained Hospitals — refers to all hospitals under the management and operation of the DOH.

4. Specialty Hospitals — refers to the four (4) corporate hospitals under the DOH namely, the Philippine Heart Center (PHC), National Kidney and Transplant Institute (NKTI), Lung Center of the Philippines (LCP) and the Philippine Children's Medical Center (PCMC). TSEcAD

5. LGU Hospitals — refers to hospitals owned or managed by LGUs.

6. SUC Hospitals — refers to hospitals owned or managed by SUCs.

7. Indigent or Poor Patients — are persons who cannot meet their basic needs or who have income/s but are insufficient to fully meet their medical expenses, respectively, and are seeking medical services as in patient, whether confined in a ward, Intensive Care Unit (ICU) or small private room, or out patient in government hospitals.

V. Implementation Mechanisms

A. Eligible Beneficiaries. The beneficiaries shall be indigent or poor patients.

B. Implementation Process.

1. The DOH Central Office, specifically the DOH Financial Management Service, shall sub-allot and download the funds to retained hospitals and DOH Regional Offices.

2. The DOH Financial Management Service shall also transfer the funds to the specialty hospitals upon the signing of Memorandum of Agreement (MOA) between DOH and the heads/chiefs of these hospitals for the implementation of the program.

3. The DOH shall also enter into MOA with the Philippine General Hospital for the implementation of the program.

4. For funds downloaded to the DOH Regional Offices, the DOH Regional Directors shall enter into MOA with the LGU and SUC hospitals for the implementation of the program.

5. Downloaded or transferred funds shall be the responsibility and accountability of the head of the concerned government hospital. He shall ensure that all the downloaded or transferred funds are properly utilized consistent with COA guidelines.

6. Medical assistance extended to beneficiaries in government hospitals requiring MOA prior to the effectivity of this Order may be reimbursed and deducted from their respective fund allocation once the MOA is signed, upon submission of pertinent documents.

7. All concerned government health facilities shall ensure assistance to indigent or poor patients.

C. Approving Authority. Requests for medical assistance under the program shall be approved by the concerned Chief of Hospital.

D. Maximum Amount. The Chief of Hospital is authorized to approve a maximum amount of One Hundred Thousand Pesos (P100,000.00) per patient. Any excess shall require approval of the Secretary of Health or by his authorized representative.

E. Documentary Requirements. The applicant shall present pertinent documents (i.e., Doctor's Prescription/Request, Billing Statement, Case Summary from the concerned DSWD worker) to the concerned hospital's Medical Social Worker, who will assist the patient in availing of the medical assistance.

VI. Monitoring and Evaluation.

1. The concerned hospitals shall submit a monthly report on or before the 7th day of succeeding month of fund utilization, including (a) names and addresses of patients and medical services rendered to and/or drugs and medicines they received, (b) type of medical assistance given and other related information, and (c) the amounts given to individual patients as well as the total amount of medical assistance given for the month.

2. A Program Review shall be conducted by the DOH to assess the impact of the program on its thrusts and to commend government hospitals for their support and partnership in the utilization of the Medical Assistance Fund.

VII. Separability Clause.

If any part or provision of this Order is held invalid, the other provisions not affected shall remain in full force and effect.

VIII. Repealing Clause.

Administrative Orders 2014-0013 (dated April 7, 2014) and 2014-0017 (dated May 22, 2014) are hereby repealed. All other issuances and/or their provisions which are inconsistent with this Order concerning the utilization of the appropriations under 2014 GAA are hereby repealed.

IX. Effectivity Clause.

This Administrative Order shall take effect on July 15, 2014 upon its publication in a newspaper of general circulation or in the DOH website. ISDHEa

 

(SGD.) ENRIQUE T. ONA, MD, FPCS, FACSSecretary of Health