(NAR) VOL. 14 NOS. 3-4 / OCTOBER - DECEMBER 2003
The PhilHealth ID Card is the member's passport for the availment of Medicare benefits. The ID bears the proof of the member's program coverage for the year that commences on the 1st or 16th day of the month. As a general rule, the PhilHealth ID Card is released to an indigent member upon payment of the LGU premium counterpart by the premium sponsor/donor. It has been observed that collection of LGU premium counterpart contribution remains low due to the lenient implementation of the above Guidelines, hence the Corporation deems it necessary to address this issue.
II. DEFINITION OF TERMS
2.1 Non-delinquent LGUs and/or Donors - refers to those who have no outstanding balance or have at least paid 75% of the total LGU premium counterpart of previous year.
2.2 Delinquent LGUs and/or Donors refer to those who have more than 25% balance on previous year's total LGU premium counterpart.
3.1 Solely by an LGU;
3.2 By a Donor on behalf of the LGU;
3.3 Shared by the LGUs (i.e. barangay, municipal and provincial) or with other donors (i.e. private, legislators and national government agencies).
III. GUIDELINES (Please refer to Annex "A"[*])
The following shall be adopted specifically for the release of PhilHealth ID Cards for the Sponsored Program:
A. Initially Implementing the Program
B. Renewal of Membership Enrollment
3.1 For "Non-Delinquent" LGUs and/or Donors, the following are the requirements for the release of IDs:
3.1.1 Submission of a Certificate of Budget Allocation; and
3.1.2 Notarized Promissory Note for the payment of the first quarter premium counterpart of current year within the grace period.
3.2 For "Delinquent" LGUs and/or Donors, the following are the requirements for the release of IDs:
3.2.1 Full payment of the balance of previous year's account and submission of the Certified true copy of the Official Receipt as proof of payment;
3.2.2 Submission of a Certificate of Budget Allocation; and
3.2.3 Notarized Promissory Note for the payment of the first quarter premium counterpart of current year within the grace period.
C. Expansion of Membership Enrollment
1.1 Submission of a Certificate of Budget Allocation; and
1.2 Notarized Promissory Note for the payment of at least one (1) quarter premium counterpart within the 30 days grace period after the release of IDs.
2.1 Submission of a Certificate of Budget Allocation; and
2.2 Payment of at least one (1) quarter premium counterpart
D. Enrollment through Legislative Sponsorship
The IDs of enrolled indigent families shall be released upon submission of a copy of the Legislator's proposal for the allocation of a portion of the Priority Development Assistance Fund (PDAF) duly approved by the House Committee on Appropriation or a copy of the Special Allotment Release Order (SARO). However, the concerned Unit/Division/Group of PhilHealth shall coordinate with the Office of the Legislator and the Department of Budget and Management for the release of the Notice of Cash Allotment (NCA) of the concerned Legislator.
E. LGUs with OPB Implementation
F. Change in Effectivity Date
Should the PhilHealth ID Cards for the Sponsored Program be released beyond the thirty (30) days grace period, the LGU may opt to change the IDs' effectivity date provided no member availed of the in-patient benefits during the period.
IV. EFFECTIVITY
This Order shall take effect immediately.
Adopted: 07 July 2003
(SGD.) FRANCISCO T. DUQUE III, M.D., M.SC.
President and CEO