Medical Aid to Indigent Patients in Gov't Hospitals

The program is implemented using funding allocated in Republic Act No. 10633 (the General Appropriations Act (GAA) of FY 2014), which allocates PHP 3.193 Billion to complement the Medical Health Care Assistance Program of the Department of Health (DOH).
The fund is utilized for the grant of assistance to indigent or poor patients (Background and Rationale).
The guidelines rationalize the process in the allocation and utilization of the medical assistance fund (Objective).

The guidelines apply to all offices and persons involved in implementing medical assistance to indigent and poor patients in government hospitals (Scope).
Government Hospitals are hospitals owned or managed by government through DOH, Local Government Units (LGUs), and State Universities and Colleges (SUCs).
Medical Assistance Fund is the allocation in the 2014 GAA intended for medical assistance to indigent or poor patients.
Retained Hospitals are all hospitals under the management and operation of the DOH.
Specialty Hospitals are the four (4) corporate hospitals under the DOH: Philippine Heart Center (PHC), National Kidney and Transplant Institute (NKTI), Lung Center of the Philippines (LCP), and Philippine Children’s Medical Center (PCMC).
LGU Hospitals are hospitals owned or managed by LGUs.
SUC Hospitals are hospitals owned or managed by SUCs.
Indigent or Poor Patients are persons who cannot meet their basic needs, or who have income but are insufficient to fully meet their medical expenses, and who seek services in government hospitals as inpatients (including ward, Intensive Care Unit (ICU), or small private room) or outpatients.

The eligible beneficiaries are indigent or poor patients (Eligible Beneficiaries).
Requests for medical assistance are approved by the concerned Chief of Hospital (Approving Authority).
The Chief of Hospital is authorized to approve a maximum amount of PHP 100,000.00 per patient (Maximum Amount).
Any amount exceeding PHP 100,000.00 per patient requires approval of the Secretary of Health or his authorized representative (Maximum Amount).

The DOH Central Office, specifically the DOH Financial Management Service, sub-allots and downloads funds to Retained Hospitals and DOH Regional Offices (Implementation Process).
The DOH Financial Management Service transfers funds to Specialty Hospitals upon signing a Memorandum of Agreement (MOA) between the DOH and the heads/chiefs of the Specialty Hospitals for program implementation.
The DOH enters into an MOA with the Philippine General Hospital for program implementation.
For funds downloaded to DOH Regional Offices, DOH Regional Directors enter into MOAs with LGU and SUC hospitals for program implementation.
Downloaded or transferred funds are the responsibility and accountability of the head of the concerned government hospital, who must ensure proper utilization consistent with COA guidelines.
Medical assistance extended to beneficiaries in government hospitals that required MOA prior to the effectivity of the Order may be reimbursed and deducted from the respective fund allocation once the MOA is signed, upon submission of pertinent documents.
All concerned government health facilities must ensure medical assistance to indigent or poor patients (Implementation Process).

The applicant must present pertinent documents to the concerned hospital medical social worker, including:
- Doctor’s Prescription/Request,
- Billing Statement, and
- Case Summary from the concerned DSWD worker (Documentary Requirements).
The medical social worker assists the patient in availing of the medical assistance (Documentary Requirements).

Concerned hospitals must submit a monthly report on or before the 7th day of the succeeding month of fund utilization (Monitoring and Evaluation).
The monthly report must include:
- (a) names and addresses of patients and medical services rendered to and/or drugs and medicines they received,
- (b) the type of medical assistance given and other related information, and
- (c) the amounts given to individual patients and the total amount of medical assistance given for the month (Monitoring and Evaluation).
The DOH conducts a Program Review to assess the program’s impact on its thrusts and to commend government hospitals for their support and partnership in utilizing the Medical Assistance Fund (Monitoring and Evaluation).

The Order includes a Separability Clause: if any part or provision is held invalid, the remaining provisions not affected remain in full force and effect (Separability Clause).
The Order repeals Administrative Orders 2014-0013 (dated April 7, 2014) and 2014-0017 (dated May 22, 2014) (Repealing Clause).
All other issuances and/or provisions inconsistent with the Order concerning utilization of appropriations under the 2014 GAA are repealed (Repealing Clause).