Date Filed: 11 August 2009Pursuant to Republic Act 9288 (Newborn Screening Act of 2004) and DOH Administrative Order Numbers 2005-0005 & 2008-0026 and the maximum newborn screening fee, including the collection kit, is only 550 pesos and the maximum allowable service fee is set at 50 pesos. In compliance thereto:
1) For babies covered by the newborn care package (NCP), PhilHealth reimbursement for newborn screening tests is fixed at 500 pesos.
a. The maximum out-of-pocket payment for PhilHealth members should only be 100 pesos.
b. Other newborn care services such as eye prophylaxis, umbilical cord care, Vitamin K, thermal care, BCG and Hepatitis B immunization should also be given as it is reiterated that partial provision of services will cause non-payment of claims for the NCP.
2) To achieve the 85% target for newborn screening coverage by 2010, it is reiterated that all newborns delivered in PhilHealth-accredited facilities should undergo newborn screening tests including sick babies who are not covered by the NCP.
a. Sick newborns are covered by the regular inpatient benefit of PhilHealth.
b. The maximum payment for newborn screening test is 600 pesos, including the service fee.
c. Cost for newborn screening test shall be charged against PhilHealth benefit earmarked for laboratory, X-ray, supplies and others, e.g., 3,200 pesos for case type A in a tertiary hospital.
3) Names of facilities that refuses to provide newborn screening and/or collect more than the maximum allowed newborn screening fee shall be forwarded to the Department of Health and PhilHealthâs Legal Services Sector for investigation.
This Circular shall take effect for all claims with admission dates starting September 1, 2009.
All other issuances inconsistent herewith are hereby modified or repealed accordingly.
Adopted: 28 July 2009
(SGD.) DR. REY B. AQUINO
President and CEO
