Question & AnswerQ&A (DOH Administrative Order No. 2015-0031)
The main purpose is to update and implement guidelines for the classification of patients in government hospitals and charity clinics based on their financial capacity, in accordance with Republic Act No. 747.
These guidelines apply to all government healthcare institutions and charity clinics in the Philippines.
Eligible beneficiaries include indigent or poor patients and partial pay patients who seek medical services in government hospitals or charity clinics.
They are persons who cannot meet their basic needs or have insufficient income to fully cover their medical expenses, whether as inpatients or outpatients in government hospitals or charity clinics.
Partial pay patients have the capacity to meet their basic needs but their income is insufficient to fully pay for medical expenses, unlike indigent patients who cannot meet basic needs.
All expenses related to treatment including laboratory, diagnostic procedures, minor and major surgeries, dental services (excluding prophylaxis and prosthesis), drugs, medicines, medical supplies, and minimal professional fees for cases not covered by PhilHealth.
Indigent or poor patients are not required to pay any patient share; the government hospital bears the entire cost related to their treatment.
Partial pay patients are required to pay up to 10% of fees related to their treatment, with the hospital sharing up to 90% of the fees.
Applicants must present either the latest Income Tax Return, payslip, other proofs of income, or a Certificate of Indigency from the Department of Social Welfare and Development or its local offices, or from the Barangay Chairman.
Administrative Order No. 51-A s. 2001 and all other administrative orders implementing Republic Act No. 747 are repealed and superseded by this order.
It took effect upon its publication in a newspaper of general circulation after July 24, 2015.
Full Pay Patients are those who have capacity to meet full treatment costs and are accommodated in large private hospital rooms or suites.
Yes, minimal professional fees on cases not covered by PhilHealth, such as reader's fees, are covered for indigent patients.
The poverty incidence is 25.8%, representing families/individuals below the poverty threshold, which justifies the need for fee regulation to support patients with inadequate income.
If any part of the order is declared invalid, the other sections not affected shall remain in full force and effect.