Title
PhilHealth accreditation of HIV treatment hubs
Law
Philhealth Circular No. 2018-0004
Decision Date
Jun 18, 2018
PhilHealth Circular No. 2018-0004 establishes accreditation procedures for stand-alone and satellite HIV treatment hubs to enhance access to the Outpatient HIV/AIDS Treatment Package, ensuring that these facilities provide comprehensive care and services to people living with HIV.

Law Summary

Scope and Coverage

  • Applicable to all stand-alone HIV treatment hubs and satellite treatment hubs (primary HIV care facilities).

General Guidelines

  • Facilities must be recognized by DOH and listed officially as HIV treatment hubs or satellite hubs.
  • Accreditation as OHAT Package providers by PhilHealth is mandatory.
  • Compliance with PhilHealth Circular 011-2015 and subsequent guidelines on benefit availment and claims processing is required.
  • Facilities must adhere to the latest DOH policies on Antiretroviral Therapy (ART) usage among PLHIV.
  • Facilities shall offer comprehensive services to PLHIV including:
    • Laboratory testing for drug toxicity and treatment response (CD4 count, viral load), with referral MOA if needed.
    • Adherence and psychosocial counseling.
    • Management of PLHIV per current treatment guidelines.
    • INH and Co-trimoxazole prophylaxis.
    • Referral mechanisms for hospital admissions, TB treatment, co-infections, and other relevant services.
  • Accreditation process follows Provider Engagement through Accreditation and Contracting of Health Services protocols.
  • Required accreditation documents include performance commitment, provider data record, participation fee, photos of facility, location map, and DOH certification.
  • Annual renewal requires submission of similar documents plus an audited financial statement by June 30.
  • Exemption is given from the usual three-year operation prerequisite for accreditation.
  • Physicians rendering services must be PhilHealth-accredited.
  • Facilities already accredited and designated as treatment hubs need only update documents without separate accreditation.
  • Reimbursement funds must be used exclusively for PLHIV health services.
  • Facilities must utilize DOH-certified Electronic Medical Record or Hospital Information System.

Monitoring and Evaluation

  • Based on the PhilHealth Health Care Provider Performance Assessment System.
  • Facilities must maintain detailed patient records including medical, laboratory, adherence data, and client satisfaction forms.
  • These records must be readily accessible for PhilHealth monitoring and evaluation.

Repealing Clause

  • All inconsistent prior issuances are repealed or amended accordingly.
  • Other non-conflicting rules and guidelines remain effective.

Effectivity

  • Circular takes effect 15 days after publication in a newspaper of general circulation.
  • Filed with the National Administrative Register at the University of the Philippines Law Center.

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