EXECUTIVE ORDER NO. 106, December 24, 1986

[ EXECUTIVE ORDER NO. 106, December 24, 1986 ]

RESTRUCTURING THE MEDICAL CARE BENEFITS UNDER THE PHILIPPINE MEDICAL CARE PLAN

WHEREAS, actuarial studies show that without increasing contributions, current benefits under the Philippine Medical Care Plan, otherwise known as the Medicare Program can be increased for certain items only and at different rates for the two sectors of beneficiaries covered:

NOW, THEREFORE, I, CORAZON C. AQUINO, President of the Philippines, do hereby order:

SECTION 1. The medical care benefits to Medicare beneficiaries covered by the Social Security System (SSS) shall not exceed the rates indicated below:

HOSPITAL CATEGORY

BENEFIT

PRIMARY

SECONDARY

TERTIARY

1. Room and Board

P 30/day

P 35/day

P 45/day

2. Medical Expense (per single period of confinement)

2.1 Ordinary Cases

2.1.1 Drugs & Medicines

175

200

300

2.1.2 X-ray / Laboratories / Others

75

150

350

2.2 Intensive Care Cases

2.2.1 Drugs & Medicines

375

400

500

2.2.2 X-ray / Laboratories / Others

125

200

500

2.3 Catastrophic Cases

2.3.1 Drugs & Medicines-

800

1.000

2.3.2 X-ray / Laboratories / Others

400

1.000

3. Medical / Dental Practitioner's Fee shall be P 15.00 per day not to exceed

3.1 For Ordinary Cases (per single period of confinement)

200

200

200

3.2 For intensive Care / Catastrophic Cases (Per single period of confinement)

300

300

300

4. Surgeon's Fee shall be in accordance with the relative value scheme prescribed by the Commission not to exceed P 650.00

5. Anesthesiologist's Fee not to exceed 30% of the allowed Surgeon's fee.

6. Operating Room Fee for Surgical Procedures with Relative Unit Value of:

0 - 5

30

35

65

5.1 - 10

-

120

165

10.1 - Above

-

170

225

7. Fees for surgical family planning procedures as may be determined by the commission

SECTION 2. The medical care benefits of Medicare beneficiaries covered by the Government Service Insurance System (GSIS) shall not exceed the rates indicated below:

HOSPITAL CATEGORY

BENEFIT

PRIMARY

SECONDARY

TERTIARY

1. Room and Board

P 20/day

P 24/day

P 33/day

2. Medical Expense Benefits (Per single period of confinement)

2.1 For Ordinary Cases

2.1.1 Drug & Medicines

150

175

250

2.1.2 X-ray / Laboratories / Others

50

75

100

2.2 For Intensive Care Cases

2.2.1 Drug & Medicines

250

300

350

2.2.2 X-ray / Laboratories / Others

100

125

250

2.3 Catastrophic Cases

2.3.1 Drugs & Medicines

-

400

450

2.3.2 X-ray / Laboratories / Others

-

150

300

3. Medical / Dental Practitioner's Fee shall be P 15.00 per day not to exceed:

3.1 For Ordinary Cases (per single period of confinement)

200

200

200

3.2 For Intensive Care / Catastrophic Cases (per single period of confinement)

300

300

300

4. Surgeon's Fee shall be in accordance with the relative value scheme prescribed by the Commission not to exceed P 650.00

5. Anesthesiologist's Fee not to exceed 30% of the allowed Surgeon's Fee

6. Operating Room Fee for Surgical Procedures with relative Unit Value of:

0 - 5

30

35

65

5.1 - 10

-

120

165

10.1 - above

-

170

225

7. Fees for surgical family planning procedures as may be determined by the Commission

SECTION 3. All laws, orders, issuances, rules and regulations or parts thereof inconsistent with this Executive Order are hereby repealed or modified accordingly.

SECTION 4. This Executive Order shall take effect immediately:

Done in the City of Manila, this 24th day of December in year of Our Lord, nineteen hundred and eighty-six.

(Sgd.) CORAZON C. AQUINO

President of the Philippines

By the President:

(Sgd.) JOKER P. ARROYO Executive Secretary