Supreme Court E-Library
Information At Your Fingertips

  View printer friendly version

Adopted: 30 July 2015
Date Filed: 02 September 2015
1. BACKGROUND:

PhilHealth Circular 14 s. 2003 defined the dialysis benefit package and the standards for accreditation of dialysis clinics (DC), both hemodialysis (HD) and peritoneal dialysis (PD). This saw the increasing number of DCs performing hemodialysis. PhilHealth Circular 06 s. 2006 further clarified the dialysis package and defined the requirements for accreditation of dialysis clinics providing peritoneal dialysis (PD). Despite the issuance of the policy, only a few DCs have performed peritoneal dialysis. In addition, there is a need to revise the standards for accreditation of dialysis clinics performing peritoneal dialysis to ensure that the provisions of care will result to desired health outcomes.

The Corporation has taken a policy of strengthening peritoneal dialysis first (PD First) as the initial line of treatment for Filipinos with End Stage Renal Disease requiring renal replacement therapy through PhilHealth Circular 18 s. 2014. Hemodialysis, on the other hand, shall be a second line treatment for those not suitable for peritoneal dialysis and an option for patients who shall seek hemodialysis as their preference when their healthcare provider has adequately explained all treatment options to them.

II. OBJECTIVES

This Circular aims to provide guidelines on the standards for accreditation of dialysis clinics providing peritoneal dialysis.

III. COVERAGE

This Circular shall apply to Health Care Institutions (HCIs) that intend to provide Peritoneal Dialysis services and those currently accredited HCIs with intent to enter into contracts as “PD First” Z Benefit providers.

IV. GENERAL GUIDELINES:

1. Accreditation of HCIs shall be in accordance with PhilHealth Circular 54 s. 2012 “Provider Engagement and Accreditation through Contracting of Health Care Services” and subsequent issuances.
   
   

   1.1	A Peritoneal Dialysis Clinic (PDC) applying for initial accreditation shall be exempted from the three (3) years in operation requirement. It shall comply with accreditation requirements and shall undergo pre- accreditation survey (PAS). On subsequent accreditation cycle, the HCI shall comply with requirements and shall be subjected for monitoring.
   1.2	Accredited HCIs with intent to provide Peritoneal Dialysis as an additional service shall submit to PhilHealth a new Provider Data Record (PDR) and Performance Commitment, and shall undergo pre- accreditation survey. On subsequent accreditation cycle, the HCI need not apply for a separate accreditation given that it is already a part of the HCI.

   
   
   
2. Currently accredited HCIs with intent to provide “PD First” shall submit a letter of intent (LOI) and shall follow the guidelines as provided in PhilHealth Circular No. 018 S. 2014 “PD First Z Benefits: The Z Benefits For End-Stage Renal Disease Requiring Peritoneal Dialysis”. The guidelines for contracting of Z benefit providers shall be provided in another issuance.
   
   
3. Currently accredited HCIs and dialysis clinics performing hemodialysis are encouraged to provide Peritoneal Dialysis services.
   
   
4. Every Peritoneal Dialysis unit (PDU)/Peritoneal Dialysis Clinic (PDC) shall be headed by a PhilHealth - accredited physician.
   
   
5. The PDU/PDC Head shall be allowed to manage a maximum of three (3) dialysis units (can be a combination of HD and PD).
   
   
6. All PDCs shall have a Memorandum of Agreement (MOA) with at least Level 1 accredited hospital as its referral hospital.

V. STANDARDS FOR ACCREDITATION

1. Human Resource
   Every PDC/PDU shall have an adequate number of qualified and competent staff to ensure efficient and effective delivery of PD services.
   
   
2. Minimum Service Capability
   Every PDC/ PDU shall ensure provision of the minimum services is of the desired quality.
   
   
3. Physical Plant
   The PDC/PDU shall have physical facilities with adequate areas to ensure the safety of the staff, patients and their relatives.
   
   
4. Equipment and Supplies
   The PDC/PDU clinic shall have available and operational equipment, instruments, materials and supplies for PD procedures. It shall also provide a desktop with online connection and a functional HCI portal.
   
   
5. Records
   Every PDC/PDU clinic shall maintain a record system to provide readily available information on each patient.
   
   
6. Protocols
   Every PD clinic shall have procedures on routine PD care and how to address common problems encountered in performance of the PD procedure.

VI. REQUIREMENTS FOR ACCREDITATION

All Health Care Institutions that are qualified to provide the PD services shall apply by filling up the Provider Data Record (PDR) and submit all documentary requirements.

VII. MONITORING

The Corporation shall regularly undertake monitoring and evaluation activities to assess the adequacy of implementation and aid in the continuous enhancement of the PD benefit. The general guidelines for monitoring shall be anchored in the Health Care Provider Performance Assessment System of the Corporation (PhilHealth Circular 31, 2014) to evaluate the following but not limited to these parameters: quality of care, access to PD services, patient satisfaction, financial risk protection to members and fraud detection.

VIII. REPEALING CLAUSE

All provisions of previous issuances that are inconsistent with any of the provisions of this circular are hereby amended/ modified/ or repealed accordingly.

IX. SEPARABILITY CLAUSE

In the event that a part or provision of this Circular is declared unauthorized or rendered invalid by any Court of Law or competent authority, those provisions not affected by such declaration shall remain valid and effective.

X. EFFECTIVITY:

This circular shall take effect fifteen (15) days from publication in an official gazette or any newspaper of general circulation. This shall also apply to all applications for participation that are still in process upon the effective date of this circular.

XI. ANNEXES

The following annexes shall be available at www.philhealth.gov.ph:

A Definition of terms
B Standards for accreditation for Peritoneal Dialysis
C Requirements for accreditation for Peritoneal Dialysis

(SGD) ALEXANDER A. PADILLA
President and CEO