PHIC PHILHEALTH CIRCULAR NO. 33, S. 2009, September 01, 2009

[ PHIC PHILHEALTH CIRCULAR NO. 33, S. 2009, September 01, 2009 ]

AMENDMENT TO PHILHEALTH CIRCULAR NO. 25, S. 2009 - PHILHEALTH COVERAGE FOR CONFIRMED CASES OF NOVEL INFLUENZA A (H1N1) IN HUMANS

Date Filed: 23 September 2009

Relative to the increasing number of confirmed Influenza A (H1N1) cases in the country and the Department of Health’s policy of shifting from containment of infection to mitigation strategy, the revised rules in claims reimbursement of benefit for Influenza A (H1N1) are as follows:

1. Payment of benefit for Influenza A (H1N1) stated in PhilHealth Circular No. 25, s. 2009 is applicable to all accredited hospitals.

2. However, starting September 1, 2009, the benefit payment stated in PhilHealth Circular No. 25, s. 2009 shall only be applicable to Level 3 & 4 (Tertiary) hospitals. On the other hand, payment for Level 1 (Primary) and Level 2 (Secondary) hospitals are as follows:

BENEFIT ITEMS Level 1 (Primary) Level 2 (Secondary)

Members/Dependent

HCW

Members/ Dependents

HCW

Room and Board 500 per day Max = 10,000 500 per day Max = 20,000 700 per day Max = 10,000 700 per day Max = 20,000

Drugs and Medicines X-ray, Laboratory and Others •Supplies including PPE •Transfer services (Ambulance)

Operating Room Fee 50,000 100,000 50,000 100,000

Professional Fee 500 per day Max=15,000 500 per day Max=30,000 700 per day Max=15,000 700 per day Max=30,000

TOTAL 75,000 150,000 75,000 150,000

All other provisions of previous issuances which are not inconsistent with this Circular remain in full force and effect.

Please be guided accordingly.

Adopted: 01 Sept. 2009

(SGD.) DR. REY B. AQUINO President and CEO