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(NAR) VOL. 14 NOS. 3-4 / OCTOBER - DECEMBER 2003

[ PHIC PHILHEALTH CIRCULAR NO. 05, S. 2002, February 05, 2002 ]

GUIDELINES ON THE RELEASE OF PHILHEALTH "MEDICARE PARA SA MASA" IDS UNDER PHILHEALTH PLAN 500



1.0 RATIONALE

To prescribe guidelines on the release of PhilHealth "Medicare para sa Masa" IDs under PhilHealth's Plan 500 in response to the commitment of Her Excellency President Gloria Macapagal-Arroyo in her 23 July 2001 State of the National Address (SONA) to enroll 500,000 urban poor families to the National Health Insurance Program (NHIP) within the Fiscal Year ending June 30, 2002.

2.0 COVERAGE

All cities and urban municipalities as classified and based on the National Urban Development and Housing Framework, developed by the Housing and Land Use Regulatory Board (HLURB) and under the direction of Housing and Urban Development Coordinating Council (HUDCC) pursuant to their mandate under Republic Act 7279.

3.0 TIME FRAME

These Guidelines cover PhilHealth "Medicare para sa Masa" IDs issued from July 1, 2001 to June 30, 2002.

4.0 PROCEDURES FOR THE RELEASE OF PhilHealth "Medicare para sa Masa" IDs

4.1 For Cash or Check Payment:

IDs shall be released upon payment of required LGU premium contribution as evidenced by a duly validated MIn - 5 Form or PhilHealth Official Receipt.

4.2 In case of premium payment other than cash or check, the following alternative schemes/arrangements shall be accepted as basis for the release of IDs:

a. Any secured or guaranteed marketable security or bond;

b. A Budget Certification ensuring availability of funds within the calendar year for the payment of LGU premium counterpart;

c. A Promissory Note or any non-bonded security supported by a Resolution from the LGU authorizing the local chief executive concerned to create indebtedness through supplemental and/or subsequent annual appropriations (Annex "A*" hereof);

d. A combination of Schemes b and c at the option of the LGU.

4.3 All PhilHealth "Medicare para sa Masa" IDs shall be distributed to the concerned LGUs fifteen (15) days before the membership validity, which is set every 1st and 16th of every month.

4.4 All PhilHealth "Medicare para sa Masa" IDs shall have a space at the back for use of the LGUs.

4.5 Late remittances of premium contributions as agreed upon shall make the LGU concerned liable for penalties at rates prescribed by the PhilHealth Board.

5.0 SEPARABILITY CLAUSE

These Guidelines prescribe for the rules on the release of PhilHealth "Medicare para sa Masa" IDs to indigent beneficiaries during the Plan 500 period which entitles them to the PhilHealth Benefit Package at the effectivity date stated therein. Their entitlement to Out Patient Benefits shall, however, be subject to the accreditation of the LGU Health Center/Rural Health Unit. Further, the release of the PhilHealth Capitation Fund (PCF) to finance the Out-Patient Benefits for the subject beneficiaries shall be deferred until the actual payment of premium by the LGU.

6.0 EFFECTIVITY

This Circular shall take effect immediately.

Adopted: 05 Feb. 2002

(SGD.) FRANCISCO T. DUQUE III, M.D., M.Sc.
President and Chief Executive Officer


* Text Available at Office of the National Administrative Register, U.P. Law Complex, Diliman, Quezon City

 

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