Question & AnswerQ&A (DOH ADMINISTRATIVE ORDER NO. 2010-0026)
The MHCAP is a program under the Department of Health providing financial assistance for medical or health care services to indigent patients and under-privileged veterans confined in selected government hospitals, utilizing the Indigency Fund.
The Indigency Fund is a special fund provided in the General Appropriations Act intended for medical care assistance of indigent patients referred by the Office of the Secretary or his representative.
Eligible beneficiaries include: 1) Walk-in or referred patients with unaffordable medical treatment and no capacity to pay; 2) Patients listed as indigent in the DSWD National Household Targeting System; 3) Patients certified as indigent or working poor by the Medical Social Work Department; 4) Patients certified by authorized DOH officials meeting eligibility criteria.
The PAU at the Central Office is responsible for overall management and administration of the MHCAP nationwide, screening and assessing eligibility of patients, coordinating with CHDs and hospitals, determining fund allocations, consolidating reports, and recommending non-PHIC members for LGU enrollment.
An indigent patient is a person or family member whose income is below the latest Per Capita Poverty Threshold of the hospital's region, or listed as poor in the DSWD's National Household Targeting System, incapable of providing for basic food and non-food needs.
Required documents include: original complete prescription for drugs/medicines; laboratory request form for lab exams; physician’s order/request form for diagnostic, therapeutic, or rehabilitative procedures; statement of account or updated summary of hospital bills; clinical abstract or medical certificate; and social work case summary or DSWD list for indigency.
The medical assistance ceiling is PhP 2,000.00 per patient, except when higher amounts are justified by the attending physician and Medical Social Worker due to medical treatment requirements.
The LOA authorizes medical assistance for patients, containing details of assistance and approval by authorized signatories. It serves as a document for hospitals to provide approved assistance and must be verified through the Web-enabled Public Assistance Information System (WEB-PAIS).
The MSWD implements the MHCAP locally, verifies eligibility, facilitates approvals, assesses other patient needs, recommends assistance, coordinates with finance for fund management, and facilitates PHIC enrollment for non-members.
Hospitals and the PAU/PACU collaborate to identify patients who are non-PHIC members and facilitate their enrollment with the LGUs to ensure they can avail of the Philippine Health Insurance Corporation benefits.
No cash or money shall be released directly to patients or their relatives—assistance is given via hospital services and items only.
PACU functions as the counterpart of the PAU Central Office, consolidates reports, monitors compliance, manages fund status via WEB-PAIS, and facilitates assistance implementation in retained hospitals.
Fund utilization reports must be submitted twice yearly: not later than July 31 of the current year and January 31 of the subsequent year, using a prescribed template.
EO No. 867 mandates adoption of the National Household Targeting System for poverty reduction which MHCAP uses to identify poor households eligible for assistance, ensuring assistance is targeted to indigent patients.
The PAU Central Office prepares monitoring templates and patient satisfaction surveys; periodic onsite monitoring by CHD PACU occurs; and program reviews assess impact and encourage improvement across DOH units.