Scope and Applicability
- These guidelines apply to all offices and personnel involved in providing medical assistance in government hospitals.
- Government hospitals include those managed by DOH, Local Government Units (LGUs), and State Universities and Colleges (SUCs).
Objective
- The guidelines aim to rationalize the allocation and utilization process of the medical assistance fund to ensure proper management and benefit delivery.
Definitions
- Government Hospitals: Hospitals owned or managed by DOH, LGUs, or SUCs.
- Medical Assistance Fund: The specific allocation from the 2014 GAA for medical assistance.
- Retained Hospitals: Hospitals managed directly by DOH.
- Specialty Hospitals: Four corporate hospitals under DOH (Philippine Heart Center, National Kidney and Transplant Institute, Lung Center of the Philippines, Philippine Children’s Medical Center).
- LGU Hospitals: Hospitals managed by Local Government Units.
- SUC Hospitals: Hospitals managed by State Universities and Colleges.
- Indigent or Poor Patients: Individuals unable to fully meet basic or medical needs, including both in-patients and out-patients.
Implementation Mechanisms
Eligible Beneficiaries
- Only indigent or poor patients qualify for assistance under the program.
Fund Allocation and Agreements
- DOH Financial Management Service sub-allots funds to retained hospitals and regional offices.
- MOAs are signed between DOH and hospital heads (including specialty hospitals and Philippine General Hospital), and between DOH Regional Directors and LGU/SUC hospitals.
- Heads of hospitals are accountable for proper fund use, compliant with COA guidelines.
- Assistance provided before MOA effectivity may be reimbursed upon documentation and MOA signing.
Approving Authority
- The Chief of Hospital approves medical assistance requests.
Maximum Assistance Amount
- Up to Php100,000 per patient can be approved by the Chief of Hospital.
- Any amount exceeding Php100,000 requires authorization from the Secretary of Health or an authorized representative.
Documentary Requirements
- Applicants must present documents such as Doctor’s Prescription/Request, Billing Statement, and a case summary from the DSWD worker.
- Medical Social Workers assist patients in processing medical assistance applications.
Monitoring and Evaluation
- Hospitals must submit monthly reports by the 7th day of the succeeding month detailing:
- Names, addresses, and services/drugs provided to patients.
- Types of medical assistance given.
- Individual and total amounts disbursed.
- DOH conducts periodic Program Reviews to evaluate effectiveness and acknowledge hospitals’ partnership and support.
Separability Clause
- If any part of this Order is declared invalid, remaining provisions remain fully effective.
Repealing Clause
- Administrative Orders No. 2014-0013 and 2014-0017 and other inconsistent issuances are repealed.
Effectivity
- The Order takes effect on July 15, 2014, upon publication in a newspaper of general circulation or on the DOH website.