DOH Guidelines on Gov't Hospital Patient Fees

Doh Administrative Order No. 2015-0031
The Amended Guidelines for the Implementation of Republic Act No. 747 aim to provide financial relief and support for patients with limited income seeking healthcare in government hospitals and charity clinics in the Philippines.
amended guidelines implementation regulate fees

It is issued in compliance with Republic Act No. 747, which mandates the DOH to promulgate rules and regulations on regulating patient fees in government hospitals and charity clinics.

It applies to all government health care institutions and charity clinics.

To update and set realistic guidelines for classification of patients by financial condition, and enable health care institutions/clinics to classify patients eligible for financial relief.

Indigent or poor patients and partial pay patients.

A person who cannot meet basic needs or has income but it is insufficient to fully meet medical expenses, and is seeking government/charity medical services as inpatient (ward/ICU/small private room) or outpatient.

A person who can meet basic needs but whose income is insufficient to fully meet medical expenses, seeking inpatient (ward/ICU/small private room) or outpatient services in government/charity facilities.

A person who can meet basic needs and can pay the full cost of medical treatment, typically associated with large private rooms or suites.

The hospital covers all expenses related to treatment inclusive of laboratory/diagnostics and surgeries (non-aesthetic), dental services (except prophylaxis and prosthesis), prescribed drugs/medicines/medical supplies, and minimal professional fees on cases not covered by PhilHealth; patient share is none.

The hospital covers up to 90% of fees related to the patient’s treatment, including diagnostic procedures and surgeries, certain dental services, prescribed drugs/medicines/medical supplies, and minimal professional fees not covered by PhilHealth; the patient pays the remaining portion not covered by the partial payment.

Hospital share is none; the patient pays all fees required by the hospital.

Laboratory and other diagnostic procedures, including minor and major surgical procedures, whether emergency or elective, as required by the attending physician (except those for aesthetic purposes).

Prophylaxis and prosthesis are excluded; examination and extraction are generally included except for those excluded categories.

Procedures for aesthetic purposes are excluded from the covered treatment categories for the hospital/patient sharing scheme.

The latest Income Tax Return or pay slip or other proof of income; or a Certificate of Indigency from DSWD (including its local district office or Municipal Social Welfare and Development Office with jurisdiction); or a Certificate of Indigency from the Barangay Chairman with jurisdiction over the applicant’s residence.

It takes effect upon its publication in a newspaper of general circulation.

If any part or provision is held invalid, the remaining provisions not affected remain in full force and effect.

Administrative Order No. 51-A s. 2001 and all other administrative orders implementing Republic Act No. 747 are repealed.