Implementation of the Enhanced "PCSO Medicare Access" Program

January 29, 2004

EXECUTIVE ORDER NO. 276

IMPLEMENTING THE ENHANCED "PCSO GREATER MEDICARE ACCESS" PROGRAM

WHEREAS, Section 11, Article XIII of the 1987 Constitution declares that the State shall adopt an integrated and comprehensive approach to health development which endeavor to make essential goods, health and other services available to all the people of affordable cost;

WHEREAS, Republic Act (R.A.) No. 7875 or the National Health Insurance Act of 1995, which aims to provide all Filipinos access to quality health services through an enhanced Medicare program, was enacted to operationalize the aforesaid constitutional mandate;

WHEREAS, pursuant to R.A. No. 7875 and its Implementing Rules and Regulations, the premium contributions for indigent members under the National Health Insurance Program (NHIP) are subsidized by the National Government (NG) and the local government unit (LGU) where the indigents reside;

WHEREAS, there is a prevalent clamor for the prioritization and acceleration of the universal coverage of the indigent sector under the NHIP to uplift their health, well-being and security;

WHEREAS, the universal coverage of the indigent sector under the NHIP is being hampered by the financial inability of several LGUs to provide counterpart subsidy of contribution for the enrollment of their constituent indigent families under the NHIP as required by R.A. No. 7875;

WHEREAS, part of the powers exercised by LGUs under the Local Government Code are those which relate to the promotion of the health and safety of the constituents especially the poor; ESDHCa

WHEREAS, pursuant to the Local Government Code, the barangay is mandated to ensure delivery of basic services particularly health and social welfare services;

WHEREAS, pursuant to Administrative Order No. 277 dated June 25, 1996, the concerned government agencies were directed to ensure the immediate and effective implementation of the NHIP.

WHEREAS, in April 2003, the Philippine Health Insurance Corporation (PhilHealth),in partnership with the Philippine Charity Sweepstakes Office (PCSO),implemented the PCSO Greater Medicare Access Program that covered a total of 539,670 indigent families in local government units;

WHEREAS, PhilHealth and the PCSO jointly conceptualized and formulated the enhanced PCSO Greater Medicare Access Program (the "Program") to further accelerate the coverage of indigents or the sponsored sector under the NHIP with PCSO paying the full LGU counterpart and DBM the national government counterpart;

WHEREAS, the National Government (NG),thru the Office of the President (OP) and the PCSO, has thus earmarked funds for the purpose of assisting the concerned LGUs to finance their counterpart subsidy or contribution for the enrollment of their constituent indigent families, with the end in view of accelerating the universal coverage of the indigent sector under the Program by enrolling five million additional indigent families. CDTAbench

NOW, THEREFORE, I GLORIA MACAPAGAL-ARROYO, President of the Republic of the Philippines, by virtue of the powers vested in me by law, do hereby order:

SECTION 1. Local Government Units.— The LGU are hereby directed to:

a. Avail themselves of funding assistance for their counterpart subsidy requirements for the enrollment of their constituent indigent families under the Program. aHCSTD

b. Sustain membership of indigent families under the Program by henceforth allocating funds to constituent indigent families under the Program.

SECTION 2. PhilHealth.— PhilHealth is hereby directed to:

a. Assist in the identification of indigent families and to target the enrollment of a total of the five (5) million indigent families nationwide under the enhanced "PCSO Greater Medicare Access" Program.

b. Issue PhilHealth Identification Cards to duly qualified beneficiaries.

c. Formulate and issue the Implementing Guidelines of this Order through a joint circular with PCSO.

d. Perform all other acts necessary for the effective implementation of the Program.

SECTION 3. PCSO.— PCSO is hereby directed to:

a. Remit to PhilHealth the LGU premium counterpart for duly qualified beneficiaries pursuant to the Implementing Guidelines of this Order.

b. Help facilitate the identification and enrollment of qualified indigent families in coordination with local Social Welfare Officers and/or the Punong Barangay and exert efforts necessary to facilitate and expedite the same, consistent with existing rules, procedures and guidelines.

c. Issue appropriate resolutions, memoranda and office orders to formally adopt the enhanced "PCSO Greater Medicare Access" Program and perform all other acts necessary to ensure its smooth implementation.

d. Formulate and issue the Implementing Guidelines of this Order through a joint circular with PhilHealth.

SECTION 4. Department of Budget and Management (DBM).— DBM is hereby directed to:

a. Allocate and facilitate the timely release of funds as payment for the National Government (NG) premium counterpart to PhilHealth for the coverage of duly qualified beneficiaries.

b. Perform all other acts necessary for the effective implementation of the Program. DIESHT

SECTION 5. Department of Interior and Local Government (DILG).— DILG is hereby directed to:

a. Instruct its regional, provincial and municipal offices to mobilize their personnel to help the identification of beneficiaries, in consultation with the Punong Barangay and to provide other support services as may be deemed necessary.

b. Instruct its regional, provincial and municipal offices to mobilize their personnel to help the identification of beneficiaries, in consultation with the Punong Barangays and to provide other support services as may be deemed necessary.

c. Perform all other acts necessary for the effective implementation of the Program.

SECTION 6. Department of Health (DOH),Department of Agrarian Reform (DAR),and Department of Social Welfare and Development (DSWD).— DOH, DAR and DSWD are hereby directed to:

a. Assist in the identification and enrollment of qualified indigent families in the Program. cEHITA

b. Instruct their respective regional, provincial and municipal offices to mobilize their personnel to help in the identification of beneficiaries, in consultation with the Punong Barangays and to provide other support services as may be deemed necessary.

c. Perform all other acts necessary for the effective implementation of the Program.

This Executive Order shall take effect immediately.

DONE in the City of Manila, this 29th day of January, in the year of Our Lord, Two Thousand and Four.