PHIC PHILHEALTH CIRCULAR NO. 07, S. 2011, May 17, 2011

[ PHIC PHILHEALTH CIRCULAR NO. 07, S. 2011, May 17, 2011 ]

NEW REIMBURSEMENT SCHEME FOR INFLUENZA A (H1N1)

In compliance to PhilHealth Board Resolution No. 1494, series of 2011, claims for cases of Influenza A (H1N1) shall now be paid as Case Type A under the fee-for-service scheme.

The World Health Organization (WHO) announced that the world is now shifting toward the post-pandemic phase of Influenza A (H1N1). Post-pandemic phase means that Influenza A (H1N1) virus has taken on a behavior and intensity similar to that of the regular seasonal flu viruses.

In consideration of this change in behavior of Influenza A (H1N1) virus, the Corporation amends PhilHealth Circular Nos. 25 and 33 series of 2009 and shall no longer pay Influenza A (H1N1) as a special benefit package.

Moreover, the ICD 10 code that shall be used for all claims for Influenza A (H1N1) is as follows:

ICD 10 Code

Description

Case Type

J09

Influenza due to identified Avian Influenza Virus

A

This Circular shall take effect fifteen (15) days after its publication in the Official Gazette or in a newspaper of general circulation.

All provisions of previous issuances that are inconsistent with any provisions of this Circular are hereby amended or repealed accordingly.

Adopted: 17 May 2011

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