EXECUTIVE ORDER NO. 269
EXECUTIVE ORDER NO. 269 - AMENDING
PRESIDENTIAL DECREE NO. 1519, ENTITLED “REVISING THE PHILIPPINE
MEDICARE ACT OF NINETEEN HUNDRED AND SIXTY NINE”
WHEREAS,
to make the Philippine Medical Care Plan more responsive to its
objectives, in view of the reorientation and structuring of health
policies, programs and organizations, and to have a more effective
administration of the Medicare Program, there is a need to amend
further the Revised Philippine Medical Care Act.
NOW, THEREFORE, I, CORAZON C. AQUINO, President of the Philippines, by
virtue of the powers vested in me by the Constitution, do hereby order:
Section 1. Sec. 4 (k) of Presidential Decree No.
1519 is hereby amended to read as follows:
“(k)
Medical or Dental Practitioner. — Any doctor of
medicine or doctor of dental medicine duly licensed to practice in the
Philippines and who is accredited by the Commission in accordance with
its rules and regulations.”
Sec. 2. Sec. 5 of Presidential Decree No. 1519
is hereby amended to read as follows:
“Sec. 5. Philippine Medical Care Commission. — To carry
out the purposes and objectives of this Act, the Philippine Medical
Care Commission created by Republic Act No. 6111, hereinafter referred
to as the Commission, shall be composed of the Secretary of Health as
Chairman; an Undersecretary of Health designated by the former as
Vice-Chairman; the Administrator of the Social Security System; the
President and General Manager of Government Service Insurance System;
the Secretary of Finance; the Secretary of Local Government; the
Secretary of Labor and Employment; and four other members, one each
representing the beneficiaries, the private employers, the physicians
and the hospitals. The four other members shall be appointed by the
President of the Philippines for a term of six (6) years.
The ex-officio members may
designate their representatives who shall exercise the plenary powers
of their principals as well as enjoy the same benefits available to the
latter.”
Sec. 3. Sec. 6 of Presidential Decree No.
1519, as amended, is hereby further amended to read as follows:
“Sec. 6. Functions of the Commission. — The Commission
shall have the following functions and powers:
(a)
To formulate policies, administer and implement the
Philippine Medical Care Plan, consistent with the National Health Plan.
(b) To ensure
that medical care is provided to members covered by the Philippine
Medical Care Plan.
(c) To
organize its offices, fix the compensation of and appoint its Secretary
and such other personnel as may be deemed necessary, subject to
pertinent budget and compensation laws, rules and regulations.
(d) To
accredit medical and dental practitioners, government and private
hospitals and other facilities for participation in Medical Care Plan
under such terms and conditions as the Commission may set.
(e) To
promulgate or prescribe rules and regulations as may be necessary to
carry out the provisions and purposes of this Act.
(f) To
recommend to the President from time to time according to sound
actuarial procedures the contributions and benefits under the
Philippine Medical Care Plan as well as alternative systems in order to
insure adequate financing and effective delivery of Medical Care to all
beneficiaries of the plan.
(g) To ensure
a homogenous distribution of adequate hospital accommodations for
in-patient care through a national network of government and private
medical care facilities; and to coordinate with the Department of
Health in the implementation of the Hospital Licensure Act.
(h) To
acquire in behalf of the Republic of the Philippines, real or personal
property which may be necessary or expedient for the attainment of the
purposes of the Commission.
(i) To enter
into agreements or contracts in the manner and under such terms and
conditions as the Commission may deem proper for the efficient and
effective administration of the Commission.
(j) To adopt
control measures to prevent abuses of the Philippine Medical Care Plan.
(k) To render
decisions, orders or resolutions or any investigation conducted upon
its own initiative or upon complaint in writing for any violation of
this law or its rules and regulations, and after notice and hearing,
impose administrative fines of not less than P5,000 but not more than
P30,000 against any person, natural or judicial, found guilty of such
violation: Provided, That should the violation be committed by a
hospital, drugstore, medical or dental practitioner, the accreditation
so extended shall, in addition, be suspended or revoked: Provided,
further, That should the violation be committed by a beneficiary, his
right to the benefits under the Medicare Program shall, in addition, be
suspended for a period not exceeding six months: Provided, furthermore,
That any decision, order or resolution rendered by the Commission shall
be appealable to the Office of the President in accordance with the
procedure established under Administrative Order No. 18, series of
1987: Provided, finally, That the administrative sanctions provided
herein shall be without prejudice to the penal provisions under Sec. 28 hereof.
(l) To issue
as soon as the decision, order or resolution has become final and
executory writs of execution enforceable in accordance with the Rules
of the Court of the Philippines.
(m) To
deputize any law enforcement agency or official in the execution of its
final decision, orders or resolutions and to serve such other processes
of the Commission.
(n) To submit
to the President of the Philippines annually within the first ten days
of each year, a report covering its activities in the administration of
this Act during the preceding fiscal years.
(o) To
coordinate with other appropriate government agencies in the
development of medical and allied manpower based on the needs of the
health care delivery system.
(p) To
approve rules and regulations to ensure uniform evaluation of claims as
may be elevated by the beneficiary hospitals or practitioners.
(q) Generally
to exercise all powers necessary to attain the purposes and objectives
of this Act.”
Sec. 4. The last sentence of Sec. 7 of
Presidential Decree No. 1519 is hereby amended to read as
follows:
“Each
member of the Commission shall receive a monthly commutable allowance
subject to the aforementioned laws, rules and regulations, except those
who are already receiving the same from the government offices they are
appointed to.”
Sec. 5. Sec. 8 of the Presidential Decree No.
1519 is hereby amended to read as follows:
“Sec. 8. Chairman and Vice-Chairman of the Commission. —
(a)
The Chairman shall preside over the meetings of the
Commission and shall implement its decision. He shall exercise
supervision and control over all operations of the Commission.
(b) When the
Chairman is temporarily unable to perform his functions or in case of
vacancy in the Office of the Chairman, the Vice-Chairman shall serve as
the Acting Chairman. He shall perform such other functions as may be
assigned to him by the Chairman.”
Sec. 6. Sec. 9 of Presidential Decree No. 1519
is hereby amended to read as follows:
“Sec. 9. Executive Director of the Commission. — The
Commission shall have an Executive Director who shall be appointed by
the President of the Philippines for a term of six (6) years. The
Executive Director shall have at least ten (10) years experience in
technical and administrative fields related to the purposes and
objectives of the Act. He shall hold office on a full-time basis and
shall not be removed except for cause. He shall receive such salary and
remuneration as may be determined by the Commission, subject to
pertinent laws, rules and regulations on compensation, honoraria and
allowances.
The Executive Director shall be
responsible for the general conduct of the operations and
administration of the Commission.”
Sec. 7. The second paragraph of Section 11 of
Presidential Decree No. 1519 is hereby amended to read as follows:
“In
case a person is covered both by the SSS and GSIS, he may choose under
which system he shall be covered for Medicare purposes, under such
rules as the Commission may prescribe.
Sec. 8. Section 17 of the Presidential Decree No.
1519 is hereby amended to read as follows:
“SECTION
17. Health Insurance Fund. — Payments for medical
care benefits under Program I shall be borne by the Health Insurance
Fund which shall consist of all contributions of Medicare members and
all accruals thereto collected by the SSS and GSIS from the members
under the Act. It shall be kept distinct and separate from all other
funds administered by the said agencies.
The Health Insurance Fund shall
be deposited, invested, administered, and disbursed in the same manner
and under the same conditions, requirements and safeguards as provided
by Republic Act Numbered Eleven Hundred Sixty-One as amended, and
Presidential Decree Numbered Eleven Hundred Forty-Six, as amended, with
regard to such other funds as are administered by the SSS and GSIS,
respectively: Provided, That the deposit, investment, administration,
and disbursement of the funds conform with the policies established by
the Commission: Provided, further, That the SSS and GSIS may disburse
each for operational expenses not more than twelve percent (12%) of the
total contributions and investment earnings collected during the year.”
Sec. 9. Section 18 of the Presidential Decree No.
1519 is hereby amended to read as follows:
“SEC.
18. Contributions to the Health Insurance Fund. —
The compulsory distributions of members to the Health Insurance Fund
shall be in accordance with the schedule of rates established by the
Commission and approved by the President.”
Sec. 10. Section 19 of the Presidential Decree
No. 1519 is hereby amended to read as follows:
“SECTION
19. Collection of Contributions to the Health
Insurance Fund. — The employer shall deduct from his employee’s monthly
compensation the employee’s contribution. The employee’s contribution
and the employer’s counterpart thereof shall be remitted by the
employer directly to the GSIS and SSS, as the case may be, in the same
manner as other SSS and GSIS contributions and shall be subject to the
same penalties for late payment. The employer’s counterpart
contribution shall not in any manner be recovered from the employee.
Failure of the employer to remit to the GSIS or to the SSS the
corresponding employee’s and employer’s contributions shall not be a
reason for depriving the employee of the benefits of this Decree.”
Sec. 11. Section s 24, 25 and 26 of Presidential
Decree No. 1519 are hereby revoked, and Sec. 27, 28 and 29 thereof
are hereby re-numbered as Section s 24, 25 and 26. Section s 24 and 25 of
Presidential Decree No. 1519, as renumbered herein, are hereby amended
to read as follows:
“Sec. 24. Records and Reports. — The Commission, the SSS
and GSIS shall kept records of all operations relative to the Program.”
“Sec. 25.
Program Monitoring, Study and Research. — The Commission shall
undertake a continuing monitoring study and research to improve the
Program.”
Sec. 12. A new Sec. 27 is hereby added to
Presidential Decree No. 1519, to read as follows:
“Sec. 27. Preventive Suspension. — The Hearing Committee
may preventively suspend any beneficiary, duly accredited practitioner,
hospital, or other facility from participation in the Program if any of
the following circumstances is present:
1.
When the respondent has been found guilty of a
violation of this Act or of its rules and regulations at least twice
and there is reasonable ground to believe that the respondent is guilty
of the present change.
2. When the
respondent, at the time of the inspection, has committed or is
committing a violation.
The
preventive suspension order shall be for a period of not exceeding
three (3) months from the date of its issuance. The order: (a) shall
specify the violation charged, supported by the evidence of the
violation, (b) shall require the respondent to answer the charges
within a period of ten (10) days from receipt thereof, and (c) shall
require the respondent to appear on the date set for hearing the
case.”
Sec. 13. Section s 30, 31, 32, 33, 34, 35 and 36
of Presidential Decree No. 1519 are hereby renumbered as Section s 28,
29, 30, 31, 32, 33, and 34. Sec. 29 of the Presidential Decree No.
1519, as renumbered herein, is hereby amended to read as follows:
“Sec. 29. Appropriation. — Funds as may be necessary to
finance the operation, programs, and projects of the Commission in
carrying out this Decree are hereby authorized to be included in the
Annual Appropriations Law.”
Sec. 14. All laws, orders, issuances, rules and
regulations or parts thereof inconsistent with this Executive Orders
are hereby repealed or modified accordingly.
Sec. 15. This Executive Order shall take the
effect immediately.
DONE in the City of Manila,
this 25th day of July, in the year of Our Lord, nineteen hundred and
eighty seven.
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