Republic of the Philippines

Department of Health
CORDILLERA ADMINISTRATIVE REGIONAL OFFICE

LEGAL SERVICE

RE: Review of Amended Medical Assistance Program Guidelines (AO No. 2014-0024)

The following are the changes and/or additional provisions introduced by the new guidelines as
to the Medical Assistance Program.

1. The guidelines released on July 15, 2014 was in the form of an Administrative Order
thus, any inconsistent order were expressly repealed.
.
2. New rules introduced by the July 15, 2014 guidelines:

I. Eligible Patients

a. The new guidelines state that the beneficiaries shall be indigent or poor patients
and the definition of such patients can be found on Section IV (7). They are:

a.1. Those who cannot meet their basic needs
a.2. Those who have insufficient income for their medical expenses

Both must either be patients seeking medical services (confined in a ward, ICU
or small private room) or outpatients in government hospitals.

II. Downloading of funds to the concerned LGU/SUC Hospitals

a. There is no mention or any prohibition on the download of funds to the
concerned hospital from the Regional Office. Section V(4), however, allows
the DOH Regional Offices to enter into MOA with LGU and SUC hospitals
regarding the implementation of the program.


III. Approval of request for Medical Assistance

a. With regards to the approval of medical assistance requests, it is left to the
discretion of the concerned Chief of Hospital. The patient must present
appropriate documents such as, but not limited to, the following:

a.1. Doctors prescription
a.2. Billing statement
a.3. Case summary from the concerned DSWD worker (if any)

The abovementioned documents shall be presented to the concerned
hospitals medical social worker.

b. The Medical Social Worker of the Hospital shall assist the patient in availing
the assistance.

c. The Chief of Hospital may grant medical assistance up to a maximum amount
of PhP 100,000. Any excess amount shall be with approval from the
Secretary of his representative.

IV. Monitoring by the Regional Offices

a. In order to properly monitor the program, the concerned hospital must
submit a monthly report of fund utilization. Such report must be submitted
on or before the 7
th
day of the succeeding month.

The Report shall include the following:

a.1. name and addresses of patients and medical services rendered and/or
drugs and medicines received by the patients
a.2. Type of medical assistance given and other related information
a.3. Amounts given to individual patients
a.4. Total amount of medical assistance given for the month.

It is suggested that such report must be verified correct by the
Chief Accountant and noted by the Chief of Hospital.

b. DOH shall conduct a program review to assess the impact of the program.




Prepared by:

Atty. Veronica Zandra L. de Jesus
Attorney III