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Wednesday, July 17, 2024

PhilHealth cover of hemodialysis to be expanded

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The Philippine Health Insurance Corp. (PhilHealth) will increase its coverage for outpatient hemodialysis from 90 sessions to 156 sessions this year.

In a media forum on Wednesday, PhilHealth President and Chief Executive Officer Emmanuel Ledesma Jr. said this is part of their commitment to implement enhancements in the benefit packages for 2023.

“This increase in the number of sessions covered is based on standards for adequate dialysis which requires three four-hour sessions every week for chronic kidney disease Stage 5 patients,” Ledesma said.

PhilHealth Senior Vice President Israel Francis Pargas disclosed they are targeting to officially issue the new policy before August, as the 90 sessions may end around that month or the second semester of the year.

“So, we have the time until the second sem, to make sure that we can release the 156 [sessions],” he said. “We hope that by this first or second sem, we can already come out with the policy.”

Ledesma encouraged concerned members to avail of other renal replacement therapy (RRT) offers “to achieve better quality of life.”

RRT replaces the kidney’s normal blood filtering function due to failure, acute injury, and chronic disease of the organ.

It includes dialysis (hemodialysis or peritoneal dialysis), hemofiltration, hemodiafiltration, and kidney transplantation.

“PhilHealth is providing P270,000 in financial support to patients who are on peritoneal dialysis or what we call PD-First,” Ledesma said.

“And for those who have organ donors, PhilHealth pays P600,000 for renal patients qualified under our Z benefits for kidney transplantation,” he added.

Meanwhile, the House Committee on Health has approved a bill that would authorize the President to suspend and adjust the scheduled increases in PhilHealth premiums during crisis periods.

The bill would amend Republic Act 11223 or the Universal Health Care Act and give the President this power during national emergencies or calamities or when the public interest so requires. Maricel V. Cruz and Willie Casas

Last January, President Ferdinand Marcos Jr. ordered PhilHealth to suspend the implementation of the hike in monthly contributions from 4% to 4.5% due to the economic challenges faced by Filipinos because of the COVID-19 pandemic.

“Suspending the imposition of the new PhilHealth premium rates will provide much-needed relief during national emergencies or calamities and will assure Filipinos that the government is sensitive to their sentiments in this difficult time,” House Bill 6772 said in its explanatory note.

The bill was authored principally by Speaker Martin Romualdez, Majority Leader Manuel Jose Dalipe, Senior Deputy Majority Leader Ferdinand Alexander Marcos, and Tingog Party-List Reps. Yedda Romualdez and Jude Acidre.

“It is imperative that our social safety nets like PhilHealth do not strain its beneficiaries into paying more than they can already afford,” Rep. Acidre said in his sponsorship speech.

The Universal Healthcare Act mandates a 0.5 percent increase in PhilHealth contributions every year until it reaches the 5 percent limit in 2025.

During the House hearing, PhilHealth senior manager Rex Paul Recoter said the proposed suspension “should be carefully thought of” to ensure the state-run fund could continue providing benefits to its members.

He proposed that the bill include a provision allowing for consultation with stakeholders to be held before the PhilHealth board recommends the suspension of the contribution rate hike to the president.

“Please consider that PhilHealth is a social health insurance program that also depends on the premium contributions of its members to sustain its programs,” Recoter said.

He also said the implementation of an increase of PhilHealth contribution will be “upon the lifting of the state of national emergency or public health emergency or national calamity.”

However, Acidre said holding public consultations would not be feasible since under the public health emergency, the President would be given the authority to suspend PhilHealth premium rate hikes.

“Considering the emergency nature of the situation, I don’t think it’s feasible to have consultations at this point,” Acidre said. “We are confident that the PhilHealth board, on their own, are capable of making such recommendations without the need for further consultation.”


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