Implementing Guidelines on the Medical Assistance Program (MAP) of the Department of Health

May 22, 2014

DOH ADMINISTRATIVE ORDER NO. 2014-0017

 

I. BACKGROUND AND RATIONALE

On December 20, 2013, President Benigno S. Aquino III signed Republic Act No. 10633 otherwise known as the General Appropriations Act (GAA) for Fiscal Year 2014 which provided an allocation of P3.193 billion to be utilized for the Medical Assistance Program (MAP) under the Department of Health.

The Medical Assistance Program shall complement the existing assistance programs currently in place in the DOH and the guidelines set in this Administrative Order shall define the management of the MAP allocation.

II. SCOPE

This policy shall apply to all offices involved in the implementation of the MAP in the Central Office; Specialty, Special, and Retained Hospitals of the Department of Health; the Philippine General Hospital (PGH), West Visayas State University Hospital (WVSUH), other SUC Hospitals, Local Government Unit (LGU) Hospitals, and other concerned health facilities.

III. OBJECTIVE

These guidelines are promulgated to prescribe rational management and monitoring of the allocation of funds and the implementation of the MAP by the DOH Central Office; Specialty, Special, and Retained Hospitals of the Department of Health; the Philippine General Hospital (PGH), West Visayas State University Hospital (WVSUH), other SUC hospitals, Local Government Unit (LGU) Hospitals and other concerned health facilities.

IV. DEFINITION OF TERMS

1. Government Hospital — refers to a hospital created by law under the supervision of the national government through the DOH, Local Government Unit (LGU), Department of National Defense (DND), Philippine National Police (PNP), Department of Justice (DOJ), State Universities and Colleges (SUCs), Government Owned and Controlled Corporations (GOCCs) and others.

2. Medical Assistance Program (MAP) — a program of the Department of Health intended to provide medical assistance to patients seeking consultation, rehabilitation, examination or otherwise confined in government hospitals.

3. Medical Assistance Program (MAP) Fund — represents the allocation provided for in the GAA for 2014, specifically under "Assistance to Indigent Patients either Confined or Out-Patient in Government Hospitals/Specialty Hospitals/LGU Hospitals/Philippine General Hospital/West Visayas State University Hospital," and similar funds in succeeding GAAs, intended for medical assistance to patients seeking consultation, rehabilitation, examination or otherwise confined in government hospitals, regardless of room category.

4. Retained Hospitals — refers to all hospitals under the management and operation of the DOH Center for Health Development. (Annex A)

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

6. Special Hospital — refers to the hospitals under the DOH that are primarily engaged in the provision of specific clinical care and management. (Annex B) CAIHTE

7. Health Facility — refers to DOH Specialty, Special and Retained Hospitals, LGU Hospitals, SUC Hospitals, Infirmaries and such other facilities determined by the DOH.

8. MAP Indigent/Eligible Patients — patients who are seeking consultation, rehabilitation, examination or otherwise confined in government hospitals, regardless of room category.

V. GENERAL GUIDELINES

1. The budget appropriation line item "Assistance to Indigent Patients either Confined or Out-Patient in Government Hospital/Specialty Hospitals/LGU Hospitals/Philippine General Hospital/West Visayas State University Hospital" provided for in the GAA for 2014 under the Office of the Secretary, and similar funds provided for in succeeding GAAs shall be referred to as the MAP funds.

2. The MAP shall adopt a system of management that is effective and efficient.

3. The MAP shall support Kalusugan Pangkalahatan, and the achievement of Universal Health Care for all Filipinos.

VI. IMPLEMENTING MECHANISM

A. Eligible Beneficiaries

The program beneficiaries are eligible patients who are seeking consultation, rehabilitation, examination or otherwise confined in government hospitals, regardless of room category, as determined by the DOH.

B. Implementation and Approval

1. Hospital Medical Directors or Chiefs of Government Hospitals willing to avail of the MAP shall submit a Letter of Intent to the DOH Central Office indicating the following:

a. intention to avail of the MAP

b. name, contact number and email address of at least two (2) contact persons in charge of the MAP implementation in the hospital

c. preferred bank and the bank account number of the hospital (preferably Landbank of the Philippines)

2. DOH Retained Health Facilities shall be sub-allotted with funds from the DOH Central Office. aScITE

3. All funds downloaded to the hospital shall be the responsibility of the Medical Director and the use of the said funds shall strictly comply with the provisions on the Special Allocation for the Medical Assistance Program as specified in RA No. 10633, otherwise known as the General Appropriations Act of 2014.

4. Guidelines for the sub-allotment of funds for DOH Retained Health Facilities shall be formulated accordingly.

5. Non-DOH government hospitals shall enter into a Memorandum of Agreement (MOA) with the DOH, in addition to the requirement provided for in Section VI.B.1 of this Administrative Order. (Annex C)

6. Implementation of the MAP shall be in the following manner:

DOH Retained Health	DOH Retained Health	Non DOH
Facilities (with	Facilities (without	Government Health
Downloaded Funds)	Downloaded Funds)	Facilities
I.		I.		I.
Request for Medical	Request for Medical	Request for Medical
Assistance shall be	Assistance shall be	Assistance shall be
made directly to the	made to the MAP Unit	made to the MAP Unit
hospital involved
II.		II.		II.
Hospital shall provide	MAP Unit will issue a	MAP Unit will issue a
medical assistance to	Guarantee Letter. The	Guarantee Letter. The
eligible patient.	Guarantee Letter shall	Guarantee Letter shall
	contain:	contain:
	1	Name, Age and	1	Name, Age and
		Address of Patient		Address of Patient
	2	Medical Assistance	2	Medical Assistance
		Required		Required
	3	Amount of	3	Amount of
		Assistance		Assistance
III.		III.		III.
Hospital shall submit a	The Guarantee Letter	The Guarantee Letter
Fund Utilization Report	will be given to the	will be given to the
to the DOH Financial	eligible patient.	eligible patient.
and Management
Service and the MAP
Unit.
		IV.		IV.
	Eligible Patient	Eligible Patient
	proceeds to the Hospital	proceeds to the Hospital
	cashier and presents	cashier and presents
	Guarantee Letter.	Guarantee Letter.
		V.		V.
	Hospital provides	Hospital provides
	medical assistance to	medical assistance to
	the eligible patient and	the eligible patient and
	sends the bill to the	sends the bill to the
	MAP Unit.	MAP Unit.
		VI.		VI.
	MAP Unit verifies the	MAP Unit verifies the
	billing and endorses the	billing and endorses the
	same to the DOH	same to the DOH
	Financial and	Financial and
	Management Service for	Management Service for
	payment via bank  transfer.	payment via bank transfer.

 

6.1 Professional fees are not covered by the MAP funds.

6.2 No money/cash shall be released directly to patients or any relatives.

7. Utilization reports of the MAP Funds shall be prepared by the MAP Unit for monitoring and submission to concerned offices, and for posting on the DOH website.

VII. ROLES AND RESPONSIBILITIES

1. DOH-MAP Unit

a. Ensure that all concerned hospitals have complied with the requirements for the implementation of the MAP.

b. Receive requests for medical assistance from the patients of DOH Retained Health Facilities and non-DOH government Health Facilities.

c. Issue Guarantee Letters and electronically send the same to the concerned government hospital.

d. Receive monthly summary of billing from all health facilities utilizing the MAP Fund as certified by the Medical Director or Chief of Hospital.

e. Prepare disbursement vouchers and submit the same to the DOH Financial and Management Service.

f. Coordinate and collaborate with concerned government health facilities regarding all financial and administrative concerns in implementation of the program.

2. DOH-Financial and Management Service

a. Sub-allot funds to the concerned DOH Retained Health Facilities for the implementation of the MAP.

b. Facilitate the processing of Disbursement Vouchers for payment within ten (10) working days to health facilities involved in the MAP through Landbank or in the absence of a Landbank branch in the area, any bank utilized by the health facility.

c. Provide technical assistance on financial issues and concerns.

d. Consolidate the monthly fund utilization of the MAP Funds for submission to concerned offices and for posting on DOH website.

3. DOH Retained Health Facilities

a. Submit a Letter of Intent as provided for in Section VI.B.1 of this Administrative Order.

b. Receive the funds sub-allotted by the DOH Central Office for the implementation of the MAP.

c. Facilitate the implementation of the medical assistance to the eligible patient. HEITAD

d. Prepare a monthly fund utilization report and submit the same to the DOH Financial and Management Service and the MAP Unit.

e. Comply with the requirements of the provisions set in the Special Allocation for the Medical Assistance Program as specified in RA No. 10633, otherwise known as the General Appropriations Act of 2014.

4. Non-DOH Government Health Facilities

a. Submit a Letter of Intent as provided for in Section VI.B.1 of this Administrative Order.

b. Non-DOH government hospitals are required to enter into a Memorandum of Agreement with the DOH, in addition to the requirement provided for in Section VI.B.1 of this Administrative Order.

c. Facilitate the implementation of the approved medical assistance referred by the MAP Unit.

d. Submit the original copy of the monthly billing duly certified by the Medical Director or Chief of Hospital to the DOH-MAP Unit on or before the 5th day of the succeeding month.

e. Comply with the requirements of the provisions set in the Special Allocation for the Medical Assistance Program as specified in RA No. 10633, otherwise known as the General Appropriations Act of 2014.

5. DOH Regional Offices

a. Facilitate the signing of the Memorandum of Agreement between the LGU, or SUC Hospital, and the DOH for the implementation of the MAP.

b. Consolidate annual inventory reports of approved medical assistance submitted by the SECOND PARTY, including reports of far-flung hospitals and other health facilities.

c. Submit the above mentioned report to the Medical Assistance Program Unit in the Central Office.

d. Conduct periodic on-site monitoring to ensure compliance by the SECOND PARTY with the guidelines of the program.

e. Inform all Non DOH Government Health Care Facilities to accept the Guarantee Letters from the MAP Unit. aDSIHc

f. Send the names of contact persons, telephone numbers, email address and bank account number of the Non DOH Government Health Care Facilities to the MAP Unit.

g. Monitor compliance of the Non DOH Government Health Care Facilities with the requirements of the provisions set in the Special Allocation for the Medical Assistance Program as specified in RA No. 10633, otherwise known as the General Appropriations Act of 2014.

VIII. MONITORING AND EVALUATION

1. A Program Review shall be conducted to assess the impact of the program on DOH thrusts and to commend government hospitals for their support and partnership in the implementation of the MAP.

IX. SEPARABILITY CLAUSE

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

X. REPEALING CLAUSE

All existing administrative issuances on the Medical Assistance Program utilizing the appropriation under R.A. No. 10633 otherwise known as the General Appropriations Act of 2014 are hereby repealed.

XI. EFFECTIVITY CLAUSE

These implementing guidelines shall take effect immediately upon approval.

(SGD.) ENRIQUE T. ONA, MD

Secretary of Health

ANNEX A

DOH Retained Hospitals

CHD FOR NCR

BATANES GENERAL HOSPITALBasco, Batanes

DR. JOSE N. RODRIGUEZ MEMORIAL HOSPITALTala, Caloocan City

LAS PIÑAS GENERAL AND SATELLITE TRAUMA CENTERLas Piñas City

SAN LORENZO RUIZ WOMEN'S HOSPITALO. Reyes St., Santulan, Malabon, Metro Manila

VALENZUELA MEDICAL CENTERKaruhatan, Valenzuela City

CHD FOR ILOCOS

ILOCOS TRAINING AND REGIONAL MEDICAL CENTERSan Fernando, La Union

MARIANO MARCOS MEMORIAL MEDICAL CENTERBatac, Ilocos Norte

REGION I MEDICAL CENTERDagupan City, Pangasinan

CHD FOR CORDILLERA

BAGUIO GENERAL HOSPITAL AND MEDICAL CENTERBGHMC Cmpd., Baguio City

CONNER DISTRICT HOSPITALConner, Apayao

FAR NORTH LUZON GENERAL HOSPITAL & TRAINING CENTERQuirino, Luna, Apayao

LUIS HORA MEMORIAL HOSPITALAbatan, Bauko, Mt. Province

CHD FOR CAGAYAN VALLEY

CAGAYAN VALLEY MEDICAL CENTERTuguegarao, Cagayan

SOUTHERN ISABELA GENERAL HOSPITALSantiago City

VETERANS REGIONAL HOSPITALBayombong, Nueva Vizcaya

CHD FOR CENTRAL LUZON

BATAAN GENERAL HOSPITALBalanga, Bataan

JOSE B. LINGAD MEMORIAL REGIONAL HOSPITALSan Fernando, Pampanga

MARIVELES MENTAL HOSPITALBonifacio Street, Mariveles, Bataan

PAULINO J. GARCIA MEMORIAL RESEARCH & MEDICAL CENTERCabanatuan City

TALAVERA EXTENSION HOSPITALTalavera, Nueva Ecija

CHD FOR SOUTHERN TAGALOG (CALABARZON-4A)

BATANGAS MEDICAL CENTERBatangas City

CHD FOR SOUTHERN TAGALOG (MIMAROPA-4B)

CULION SANITARIUMCulion, Palawan

OSPITAL NG PALAWANPuerto Princesa City

CHD FOR BICOL

BICOL MEDICAL CENTERNaga City

BICOL REGIONAL TRAINING AND TEACHING HOSPITALLegaspi City

BICOL SANITARIUMCabusao, Camarines Sur

CHD FOR WESTERN VISAYAS

CORAZON LOCSIN MONTELIBANO MEMORIAL REGIONAL HOSPITALBacolod City

DON JOSE MONFORT MEDICAL CENTER EXTENSION HOSPITALBarotac Nuevo, Iloilo

WESTERN VISAYAS MEDICAL CENTERMandurriao, Iloilo City

WESTERN VISAYAS SANITARIUMSta. Barbara, Iloilo

CHD FOR CENTRAL VISAYAS

DON EMILIO DEL VALLE MEMORIAL HOSPITALUbay, Bohol

EVERSLEY CHILDS SANITARIUMMandaue City

GOV. CELESTINO GALLARES MEMORIAL MEDICAL CENTERTagbilaran City

ST. ANTHONY MOTHER AND CHILD HOSPITALCebu City

TALISAY DISTRICT HOSPITALTalisay, Cebu

VICENTE SOTTO MEMORIAL CENTER

CHD FOR EASTERN VISAYAS

EASTERN VISAYAS REGIONAL MEDICAL CENTERTacloban City

SCHISTOSOMIASIS CONTROL AND RESEARCH HOSPITALPalo, Leyte

CHD FOR ZAMBOANGA PENINSULA

BASILAN GENERAL HOSPITALBasilan

DR. JOSE RIZAL MEMORIAL HOSPITALLawa-an, Dapitan City

LABUAN PUBLIC HOSPITALLabuan, Zamboanga del Sur

MARGOSATUBIG REGIONAL HOSPITALMargosatubig, Zamboanga del Sur

MINDANAO CENTRAL SANITARIUMPasobolong, Zamboanga City

SULU SANITARIUMJolo, Sulu

ZAMBOANGA CITY MEDICAL CENTERZamboanga City

CHD FOR NORTHERN MINDANAO

AMAI PAKPAK MEDICAL CENTERMarawi City

MAYOR HILARION A. RAMIRO SR. REGIONAL AND TEACHING HOSPITALOzamis City

NORTHERN MINDANAO MEDICAL CENTERCapitol Cmpd., Cagayan de Oro City

CHD FOR SOUTHERN MINDANAO

DAVAO REGIONAL HOSPITALTagum, Davao del Norte

SOUTHERN PHILIPPINES MEDICAL CENTERDavao City

CHD FOR SOCCSKSARGEN

COTABATO REGIONAL AND MEDICAL CENTERSinsuat Ave., Cotabato City

COTABATO SANITARIUMBrgy. Pinaring, Sultan Kudarat, Maguindanao

CHD FOR CARAGA

ADELA SERRA TY MEMORIAL MEDICAL CENTERTandag, Surigao del Sur

CARAGA REGIONAL HOSPITALSurigao City

ANNEX B

DOH Special Hospitals

AMANG RODRIGUEZ MEDICAL CENTERMarikina City

DR. JOSE FABELLA MEMORIAL HOSPITALLope de Vega, Sta. Cruz, Manila

EAST AVENUE MEDICAL CENTEREast Ave., Quezon City

JOSE R. REYES MEMORIAL MEDICAL CENTERRizal Avenue, Sta. Cruz, Manila

NATIONAL CENTER FOR MENTAL HEALTHMandaluyong City

NATIONAL CHILDREN'S HOSPITALE. Rodriguez, Quezon City

PHILIPPINE ORTHOPEDIC CENTERMaria Clara cor. Banawe St., Quezon City

QUIRINO MEMORIAL MEDICAL CENTERProject 4, Quezon City

RESEARCH INSTITUTE FOR TROPICAL MEDICINEFilinvest Corporate City, Alabang, Muntinlupa City

RIZAL MEDICAL CENTERPasig City

SAN LAZARO HOSPITALQuiricada St., Sta. Cruz, Manila

TONDO MEDICAL CENTERBalut, Tondo, Manila

ANNEX C

MEMORANDUM OF AGREEMENT

KNOW ALL MEN BY THESE PRESENTS:

This agreement is entered into and executed by and between:

The DOH REGIONAL HEALTH OFFICE ___, with office address at ________________, in his capacity as the Regional Director and in representation of the Department of Health, herein referred to as the "FIRST PARTY";

-and-

The __________________, a hospital operating by virtue of __________________, with office address at ________________, represented herein by ________________, in his capacity as ________________, and herein referred to as the "SECOND PARTY"

-and-

The duly elected governor of ______________________, (name of governor), with postal address at _____________________ herein referred to as the "THIRD PARTY."

WITNESSETH

WHEREAS, the FIRST PARTY, as an office of the DOH, has been providing assistance to patients seeking consultation or being admitted to government hospitals and health care facilities;

WHEREAS, the FIRST PARTY is authorized to enter into a Memorandum of Agreement (MOA) with Local Government Units (LGUs) and State Universities and Colleges (SUCs) Hospitals pursuant to Administrative Order No. _____ dated ________, 2014 (Implementing Guidelines on the Medical Assistance Program of the Department of Health);

WHEREAS, the SECOND and THIRD PARTY participation shall ensure the efficient implementation of the Medical Assistance Program (MAP) at the Provincial/District Hospital level; and

WHEREAS, to ensure a more effective and efficient system of implementation of the MAP, inclusive of a systematic reimbursement process for LGU and SUC managed hospitals, this MOA is being entered into by the Parties.

NOW THEREFORE, for and in consideration of the foregoing premises, the parties hereby agree as follows:

1. Responsibilities of the FIRST PARTY. — The FIRST PARTY shall:

1.1 Issue a letter of guarantee, through the MAP Unit personnel, to the SECOND PARTY for eligible patients.

1.2 Consolidate annual inventory reports of approved medical assistance submitted by the SECOND PARTY, including reports of far-flung hospitals and other health facilities.

1.3 Submit the above mentioned report to the Medical Assistance Program Unit in the Central Office.

1.4 Conduct periodic on-site monitoring to ensure compliance by the SECOND PARTY with the guidelines of the program.

2. Responsibilities of the SECOND PARTY. — The SECOND PARTY shall:

2.1 Facilitate the implementation of approved medical assistance to eligible patients.

2.2 Ensure the availability of medicines, medical supplies and other health care services needed by the eligible patients.

2.3 Prepare a monthly summary of report reflecting the list of patients and health care services provided. The report shall be signed by the chief accountant or his equivalent, approved by the Chief of Hospitals, and submitted to the DOH Regional Office on or before the 5th day of the succeeding month.

2.4 Secure COA post audit review over any and all transactions related to the medical assistance provided by their hospital.

2.5 Ensure that in no case shall the grant of assistance to eligible patients be delegated and/or transferred to a non-governmental organization, people's organization or other similar organizations.

3. Responsibilities of the THIRD PARTY. — The THIRD PARTY shall:

3.1 Ensure availability of medicines, medical supplies and other health care services at the Provincial/District hospitals

3.2 Ensure compliance of the SECOND PARTY of all its repertorial responsibilities under this agreement

4. Effectivity & Duration. — This agreement shall take effect upon the signing by authorized representatives of the respective parties, and shall continue to be valid and binding until terminated by any of the parties, or automatically terminated pursuant to paragraph 6 of this agreement.

5. Amendment, Modification, Addition or Deletion. — Any amendment, modification, addition or deletion of any provision of this agreement shall be agreed upon by the parties in writing.

6. Termination. — This Agreement shall automatically terminate upon the depletion of the allocation for MAP. Termination can also be commenced by any of the parties by giving written notice to the other Party. Such termination shall take effect thirty (30) days from receipt of said notice, unless otherwise qualified by the terminating party.

7. Settlement of Disputes. — The parties shall exert effort to settle amicably any dispute arising out of or in connection with the agreement or its interpretation. Should the parties fail to amicably settle said dispute, any legal action shall be filed before the courts of Manila.

8. Repealing Clause. — All existing Memorandum of Agreements (MOA) on the Medical Assistance Program between the parties mentioned in this MOA are hereby repealed.

IN WITNESS WHEREOF, all parties have signed this Memorandum of Agreement on (date) at (place).

_______________________________	_______________________________
DOH Regional Director for (place)	Chief of Hospital, (name of hospital)

 

______________________________Governor, Province of (place)

SIGN IN THE PRESENCE OF:

___________________

_________________

 

ACKNOWLEDGMENT

Republic of the Philippines)

BEFORE ME, a Notary Public, this _____th day of _____________, 2014 in __________________, personally appeared the following persons:

NAME	Government Issued I.D.	Place/Date of Issue
_____________________	_______________________	____________________
_____________________	_______________________	____________________

known to me and to me known to be the same persons who executed the foregoing Memorandum of Agreement, consisting of three (3) pages including this page, and acknowledged to me that the same is their free and voluntary act and deed, and of the institutions they respectively represent.

WITNESS MY HAND AND SEAL this ____________________ in _________________.

Doc. No. ______;