QuestionsQuestions (EXECUTIVE ORDER NO. 501)
E.O. 501 is issued by the President (Corazon C. Aquino) pursuant to powers vested by law. Its purpose is to increase Medicare benefits under the Philippine Medical Care Plan to make the program more responsive to its members and to preserve its support level.
Both GSIS and SSS Medicare beneficiaries are covered—specifically Medicare beneficiaries in the government sector (GSIS) and in the private sector (SSS).
Actuarial studies showed that the Health Insurance Fund administered by SSS and the Health Insurance Fund administered by GSIS can further finance a 20% across-the-board increase in all hospitalization items compensable under the Medicare Program.
It means the 20% increase applies to all items of hospitalization compensable under the Medicare Program, rather than only selected benefits.
It took effect on January 1, 1992 (the 1st day of January 1992).
Room and board not exceeding 45 days per year for each member of program 1, plus another 45 days per year shared by all dependents.
Primary: P55/day; Secondary: P100/day; Tertiary: P120/day.
For Ordinary Cases (per single period of confinement): Primary drugs & medicines P720; Primary x-ray/lab/other P595+125 (as indicated separately in the text). For Secondary: P1,090 (drugs) and P790 (x-ray/lab/other). For Tertiary: P1,375 (drugs) and P845 (x-ray/lab/other) with P530 shown as the other component in the text.
Per single period of confinement: Primary—drugs & medicines P1,395 and x-ray/lab/cases P1,125 (with P270 shown as the other component); Secondary—drugs & medicines P2,040 and x-ray/lab/cases P1,350 (with P690); Tertiary—drugs & medicines P3,480 and x-ray/lab/cases P2,430 (with P1,050).
For Primary hospital category, the text indicates “- - -” (no amounts stated). For Secondary: drugs & medicines P4,390 and x-ray/lab/other P3,040 with P1,350 shown. For Tertiary: drugs & medicines P6,680 and x-ray/lab/other P3,475 with P3,205 shown.
E.O. 501 provides an operating room fee based on a Commissions Relative Unit Value (RUV) scheme, with ceilings depending on RUV bands: RUV 5 & Below, RUV 5.1 to 10, and RUV 10.1 & Above.
As stated: RUV 5 & Below—Primary P140, Secondary P245, Tertiary P390; RUV 5.1 to 10—Secondary P420 and Tertiary P500 with Primary left as “-”; RUV 10.1 & Above—Secondary P960 and Tertiary P1,290 with Primary “-”.
Medical/dental practitioners’ fee is P55 per day for general practitioners and P80 per day for specialists, not to exceed per single period of confinement: P300 for general practitioners and P450 for specialists in ordinary cases, and P450 for general practitioners and P750 for specialists in intensive care/catastrophic cases.
Surgeon’s fee follows the RUV scheme prescribed by the commission and is not to exceed P7,080. Anesthesiologist’s fee is 30% of the allowed surgeon’s fee and is not to exceed P2,125.
It provides that fees for surgical family planning procedures as may be determined by the commission are compensable; the specific amounts are left to the commission’s determination.
Section 2 repeals or modifies all orders, issuances, rules and regulations, or parts thereof, inconsistent with E.O. 501.
E.O. 501 is an executive issuance (a presidential executive order) that has the force and effect of law within the scope allowed by the Constitution and the statute empowering the President; here, it amends/increases benefits under the Philippine Medical Care Plan.