national_administrative_register ADMINISTRATIVE ORDER No. 2007-0001ADMINISTRATIVE ORDER No. 2007-0001

DOH ADMINISTRATIVE ORDER NO. 2007-0001, January 05, 2007

[ DOH ADMINISTRATIVE ORDER NO. 2007-0001, January 05, 2007 ]

REVISED SCHEDULE OF FEES FOR CERTAIN SERVICES RENDERED BY THE BUREAU OF HEALTH FACILITIES AND SERVICES AND CENTERS FOR HEALTH DEVELOPMENT IN RELATION TO THE REGULATION OF HEALTH FACILITIES AND SERVICES AND VALIDITY PERIOD OF LICENSE TO OPERATE, ACCREDITATION, AUTHORITY TO OPERATE, AND CLEARANCE FOR CERTAIN HEALTH FACILITIES AND SERVICES

I. BACKGROUND/RATIONALE

On January 13, 2000, Executive Order No. 197 entitled Directing All Departments, Bureaus, Commissions, Agencies, Offices and Instrumentalities of the National Government, Including Government-Owned or Controlled Corporations, To Increase Their Rates of Fees and Charges By Not Less Than Twenty Percent was issued by the Office of the President. An earlier issuance, E.O. No. 159 s. 1994, also directed government offices to adjust their fees and charges by just and reasonable rates sufficient to cover the full cost of services rendered. However, compliance by government offices to this E.O. was poor.

Since E.O. 197, the Bureau of Health Facilities and Services (BHFS) has revised its schedule of fees for regulatory services several times, through Administrative Order No. 104 s. 2000 Revised 2000 Schedule of Fees for Services Rendered by BLR, BRL, BFAD, and NQO ; A.O. No. 102 s. 2002 for the Schedule of Fees for regulatory services for hospitals and other health facilities (i.e. Birthing Homes, Psychiatric Care Facilities); A.O. No. 118 s. for clinical laboratories; and A.O. 2005-0029 for dialysis clinics and ambulatory surgical clinics. Except for dialysis clinics and ambulatory surgical clinics, regulatory fees for health facilities have not been reviewed for the last four years.

On examination of the current fees charged by the BHFS, the fees are still very minimal compared to the actual cost of services, despite the recent adjustments. Thus for the last five years and may be even before, the Department of Health is in effect subsidizing the entry of both public and private entities in the health services market.

Under the reform mechanisms of Fourmula One for Health, the restructuring and rationalization of fees of regulatory offices is one of the strategies formulated to support and sustain the needed reforms in health regulation. When a rationalized fee schedule is coupled with an income retention policy and performance-based fund allocation, the expected outcome is improvement in the efficiency, quality of services and client-responsivement of regulatory offices.

In consideration of all of the above, the BHFS reviewed and revised the schedule of fees for regulatory services, basing the computation of fees on cost estimates of both labor and non-labor inputs used in the provision of services. Stakeholders’ comments and suggestions were taken into account in the final revisions on the fee schedule.

Another reform strategy identified in Fourmula One for Health is to make health regulation more rational and client-responsive through less frequent more intensive regulatory procedures. During the stakeholders’ consultation mentioned above, as well as in other forums, it has been suggested that the validity period of a license/accreditation should be extended. Less frequent renewal of license/accreditation would be beneficial for both the regulatory offices and their clients in terms of decreased cost. In order not to compromise the safety and quality of services in the regulated health facilities, a longer validity period should be coupled with more intensive monitoring and enforcement activities by the regulatory offices. However, the extension of the validity period of the license/accreditation can only be done for certain health facilities. For others, such as hospitals and clinical laboratories, the yearly renewal of the license is mandated by law.

II. OBJECTIVES

This Administrative Order has the following objectives:

1. Prescribe a new schedule of fees for certain services rendered by the Bureau of Health Facilities and Services and the Centers for Health Development in relation to the regulation of health facilities and services.

2. Extend the validity period of the license to operate/accreditation/authority to operate/clearance to operate for certain health facilities and services

III. SCOPE

This schedule of fees shall apply to all government and private individuals and organizations applying for a permit to construct, license to operate, accreditation, authorization, registration, and/or certification for health facilities and services regulated by the Bureau of Health Facilities and the Centers for Health Development. Government-owned hospitals are exempted from payment of registration and license to operate fees for hospitals.

The extension of the validity period shall include only the following health facilities and services: Kidney Transplant Facility, Medical Facility for Overseas Workers and Seafarers, Dialysis Clinic, Water Testing Laboratory, Dental Laboratory, Blood Bank/ Blood Center, Blood Collection Unit, Blood Station and Health Maintenance Organization.

IV. FEES, SURCHARGES AND DISCOUNTS

A. Schedule of Fees

The Bureau of Health Facilities and Services and the Centers for Health Development shall prescribe fees for their services related to the regulation of health facilities and services based on the schedule of fees presented below.

1. Permit to Construct Fee

Category Permit to Construct Fee (in PHP)

Hospital

• Level 1

1,500

• Level 2

2,000

• Level 3

2,500

• Level 4

3,000

Birthing Home

1,400

Psychiatric Care Facility

• Acute-Chronic

1,500

• Custodial

1,500

Clinical Laboratory

• Primary

1,000

• Secondary

1,100

• Tertiary

1,300

Dialysis Clinic

1,400

Ambulatory Surgical Clinic

1,400

Medical Facility for Overseas Workers and Seafarers

1,500

Drug Abuse Treatment and Rehabilitation Center

• Residential

1,000

• Non-Residential

500

2. License to Operate Fee

a. Hospital, Birthing Home, Psychiatric Care Facility

Category License to Operate Fee (in PHP)

Initial

Renewal

2007

2008

2009

2010

2007

2008

2009

2010

Hospital

• Level 1

1,600

3,300

6,500

8,000

1,200

2,300

4,500

6,000

• Level 2

1,800

3,500

7,000

8,500

1,400

2,500

5,000

6,500

• Level 3

5,500

7,500

9,500

10,500

5,000

6,500

8,500

9,500

• Level 4

6,500

8,500

11,000

12,500

5,500

7,500

9,500

11,000

Birthing Home

900

1,800

3,500

4,500

600

1,200

2,500

3,000

Psychiatric Care Facility

• Acute Chronic

1,500

3,000

6,000

7,500

1,000

2,000

4,500

5,500

• Custodial

1,200

2,500

4,500

6,000

800

1,500

3,000

4,000

b. Hospital-Based Clinical Laboratory

Category License to Operate Fee (in PHP)

Initial

Renewal

2007

2008

2009

2010

2007

2008

2009

2010

Primary 800

1,500

2,000

2,500

500

1,000

1,200

1,500

Secondary 1,000

2,000

2,500

3,000

700

1,200

1,600

2,000

Tertiary 2,000

3,000

3,500

4,000

1,700

2,500

3,000

3,500

c. Non-Hospital Based Clinical Laboratory

Category License to Operate Fee (in PHP)

Initial

Renewal

2007

2008

2009

2010

2007

2008

2009

2010

Primary 900

1,800

2,500

3,000

800

1,500

2,000

2,500

Secondary 1,100

2,200

3,000

3,500

900

2,000

2,500

3,000

Tertiary 2,000

3,000

3,500

4,000

1,700

2,500

3,000

3,500

d. Other Health Facilities and Services

Category Permit to Construct Fee (in PHP)

Initial Renewal

Dialysis Clinic

9,500

9,500

Ambulatory Surgical Clinic

14,000

14,000

Blood Bank/Blood Center

5,000

5,000

Dental Laboratory

• Primary

1,500

1,500

• Secondary

2,000

2,000

• Tertiary

2,500

2,500

3. Accreditation Fee

Category Accreditation Fee (in PHP)

Initial

Renewal

Kidney Transplant Facility

38,000

38,000

Newborn Screening Center

8,500

8,500

Medical Facility for Overseas Workers and Seafarers

13,500

13,500

Occupational Establishment Dental Clinic

2,500

2,500

Private School Dental Clinic

2,500

2,500

Water Testing Laboratory

5,000

5,000

Drug Testing Laboratory

• Screening

5,000

5,000

• Confirmatory

10,000

10,000

Drug Abuse Treatment and Rehabilitation Center

• Residential

14,000

14,000

• Non-Residential

6,000

6,000

Drug Abuse Treatment and Rehabilitation Center Personnel

• Physician

1,000

1,000

• Other Professional

500

500

• Non-Professional

500

500

4. Bond

Category Bond (in PHP)

Medical Facility for Overseas Workers and Seafarers

50,000

Drug Testing Laboratory

20,000

Drug Abuse Treatment and Rehabilitation Center

20,000

5. Authority to Operate Fee

Category Authority to Operate Fee (in PHP)

Initial

Renewal

Blood Collection Unit

1,500

1,500

Blood Station

1,400

1,400

6. Clearance to Operate Fee

Category

Initial

Renewal

Health Maintenance Organization

• Stock Corporation 50,000

50,000

• Non-Stock or Non-Profit Cooperative/

Community-based HMO 15,000

15,000

7. Registration Fee

Category

Registration Fee (in PHP)

New Hospital/Birthing Home/Psychiatric Care Facility

200

Dental Laboratory

200

8. Certification/Authentication Fee

Category Fee (in PHP)

Registered Hospital

50

Medical and HIV-AIDS Clearance Certificate of Overseas Filipino Worker

50

B. Additional Fee to be Charged by the CHD

The Center for Health Development may charge an additional fee of not more than twenty percent (20%) of the prescribed fee, depending on the actual costs incurred by the concerned CHD in the provision of the service.

C. Payment of Fees

The applicant, upon filing an application for permit to construct, license to operate, accreditation, registration, authority to operate, and/or clearance to operate, shall pay the corresponding fee to the Cashier of the Department of Health or the Center for Health Development in person or through postal money order.

For a permit to construct application, a second evaluation of floor plans shall not be charged the permit to construct fee. However, any subsequent re-evaluation of floor plans shall be charged the corresponding permit to construct fee.

D. Re-Survey Fee

If additional site visits or surveys are needed before the license to operate/accred- itation/authority to operate can be granted, a re-survey fee that is equal to one hundred percent (100%) of the license to operate/accreditation/authority to operate fee shall be charged to the applicant for each re-survey conducted by the BHFS or CHD, over and above the original license to operate/accreditation/authority to operate fee.

The re-survey fee shall be applicable to both initial and renewal of license to operate/accreditation/authority to operate.

E. Discount on Renewal Fee

If an application for renewal of license to operate/accreditation/authority to operate/ clearance to operate is filed within the renewal period for that particular health facility or service, a ten percent (10%) discount on the renewal fee shall be granted.

F. Surcharge

If an application for renewal of license to operate/accreditation/authority to operate/ clearance to operate is filed after the expiration date, a surcharge equal to fifty percent (50%) of the renewal fee shall be imposed.

G. Review of Schedule of Fees

The Bureau of Health Facilities and Services shall review and revise the schedule of fees on a regular basis.

Section IV.B to IV.G of this Administrative Order shall be applicable to all fees for regulatory services that will be set by the BHFS in the future.

V. VALIDITY PERIOD

The validity period of the license to operate/accreditation/authority to operate/ clearance to operate for the following health facilities and services shall be increased to three (3) years.

To compensate for the longer validity period and to ensure compliance to regulatory standards, the BHFS and the CHD shall intensify monitoring and enforcement activities.

Category

Validity Period

Previous

New

Kidney Transplant Facility

2 years

3 years

Medical Facility for Overseas Workers and Seafarers

2 years

3 years

Dialysis Clinic

2 years

3 years

Water Testing Laboratory 2 years

3 years

Dental Laboratory 1 year

3 years

Blood Blank/Blood Center 1 year

3 years

Blood Collection Unit 1 year

3 years

Blood Station 1 year

3 years

Health Maintenance Organization 1 year

3 years

VI. SEPARABILITY CLAUSE

In the event that any provision or part of this Order be declared unauthorized or rendered invalid by any court of law or competent authority, those provisions not affected by such declaration shall remain valid and effective.

VII. REPEALING CLAUSE

This Administrative Order shall repeal or supercede all administrative orders and previous issuances inconsistent thereof.

VIII. EFFECTIVITY

This Administrative Order shall take effect upon approval and publication in the official gazette or newspaper of general circulation.

Adopted: 05 Jan. 2007

(SGD.) FRANCISCO T. DUQUE III, MD, MSC. Secretary of Health

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