PhilHealth signs guidelines on PAGCOR, PCSO funds for Universal Health Care

PhilHealth Universal Health Care

CEBU CITY, Philippines – The Philippine Health Insurance Corp. (PhilHealth) signed a joint circular with the Department of Finance (DOF), Department of Health (DOH), Philippine Amusement and Gaming Corp. (PAGCOR), and Philippine Charity Sweepstakes Office (PCSO) for the operationalization of the allocations for the Universal Health Care (UHC) Act, on May 30, 2022.

In a statement on Wednesday, June 8, the state health insurer said that the joint circular prescribes the guidelines that will operationalize the “efficient and sustainable” funding from PCSO, PAGCOR, and the national government to PhilHealth’s individual based services under the UHC program according to Rule IX, Sec. 37.2 in relation to Sec. 37.3 of the implementing rules and regulations of the UHC Act or the Republic Act 11223.

The UHC Law provides that 50 percent of the national government share from the income of PAGCOR (as provided for in Presidential Decree No. 1869, as amended) and 40 percent of the Charity Fund, net of Documentary Stamp Tax Payments, and mandatory contributions of the PCSO (as provided for in RA No. 1169, as amended) will be transferred to PhilHealth for the improvement of its benefit packages that will cater to the vast majority of members here in the country and abroad.

PhilHealth said among the benefits that will be improved in consultation with PAGCOR and PCSO are select medical and surgical procedures; expansion of case rates for hemodialysis up to 156 sessions; enhancement of Z benefit packages for selected orthopedic implants, post kidney transplant, breast cancer, prostate cancer, cervical cancer, open heart surgery for children (ventricular  septal  defect  and  tetralogy  of  fallot), and physical medicine and rehabilitation.

PhilHealth President and CEO Dante Gierran said infusion of funds from PAGCOR and PCSO will help PhilHealth achieve UHC, especially where improving member is concerned.

The needed funding for the said benefit expansion will be released to PhilHealth through the General Appropriations Act starting the year 2023.

/bmjo

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